| Kaposi's Sarcoma (KS)
What is Kaposi’s Sarcoma (KS)?
Kaposi’s sarcoma, or KS, is a type of cancer. KS cancer cells
cause an overgrowth of small blood vessels, which in turn form small
tumors (spots or blotches) called lesions. These lesions can appear
on the skin and inside the body. Although some people without HIV
infection can get KS, HIV-related KS is much more common and aggressive.
What are the symptoms of KS?
People with KS usually develop raised, often painless lesions that
can develop any place on the body. Frequently, KS lesions appear
first on the tip of the nose or the soles of the feet. These lesions
appear reddish-purple in light-skinned people and bluish or brownish-black
in dark-skinned people. KS in the mouth can cause trouble with eating
and swallowing. KS in the gastro-intestinal area (stomach or gut)
can cause abdominal pain and gastrointestinal bleeding. If KS shows
up in a person’s lungs, they might develop a serious cough
or have shortness of breath. KS can also cause painful edema (swelling)
in the legs.
What causes KS?
Most researchers now agree that a virus called Kaposi’s sarcoma-associated
herpesvirus (KSHV), also known as human herpesvirus-8 (HHV-8), causes
KS. However, the virus alone is not enough to cause KS. Abnormalities
of the immune system, such as in people with AIDS, may allow the
virus to cause disease. Researchers are still studying how this
virus causes KS lesions.
HHV-8 is spread primarily through saliva, but it can also be spread
through semen and blood, and from mother to baby. For these reasons,
it is a good idea to practice those behaviors that are known to
reduce risk, such as using condoms or other latex barriers for oral
and anal sex, and for rimming (placing your mouth on or around someone’s
anus) or using clean needles if you use IV drugs.
Who gets KS?
Improvements in HIV treatments, such as the availability of protease
inhibitors and the use of combination therapy, have dramatically
reduced the number of new KS cases. However, it still occurs.
KS is unusual in that here in the U.S. it develops mainly (90 percent
or more) in gay and bisexual men. The small minority of women with
KS are thought to have acquired it through sex with gay or bisexual
men. However, although HIV-related KS is rare in women, if you are
female and think you might have KS, you should see your doctor right
away.
How is KS diagnosed?
If you notice new spots on your body, have shortness of breath with
a cough or have persistent abdominal pain, be sure to tell your
doctor right away. To find out if the spots, or lesions, on the
skin or inside the body are KS, your doctor will probably perform
a test known as a biopsy. In a biopsy, a sample of cells from the
lesion are removed and examined under a microscope. It is important
to have a doctor confirm possible KS by doing a biopsy because other
diseases can produce skin lesions that appear similar. In addition,
you may need other specialized tests to tell if you have KS in your
internal organs (lungs, liver, or stomach).
Can KS be treated?
Not only has combination therapy using anti-HIV drugs helped reduce
the number of new KS cases, it has also been shown to help people
who already have KS. Because KS usually occurs when HIV damages
the immune system, combination therapy can repair the immune system
and help treat KS or prevent new lesions from occurring.
KS lesions of the skin are not usually life threatening and might
not need to be treated. However, even if the KS is not causing pain
or other problems, some people might want to have it treated because
of how it looks.
Some treatments can be applied directly to the lesion. However,
they might not prevent new lesions from occurring. Chemotherapy
drugs given through an intravenous (IV) line can both treat existing
lesions and prevent new lesions from occurring, but they can cause
serious side effects.
No treatment is 100% effective 100% of the time. In most studies,
only a small number of patients actually see their KS lesions disappear
completely. Some patients may not see their lesions disappear, but
may see a dramatic improvement in their size, shape, color, and
bulkiness. Others may not experience any noticeable changes, but
may stop new lesions from developing.
A person with KS should ask their doctor for a referral to an oncologist
(cancer doctor) for a consultation.
Ask your doctor about the following treatments for KS:
- Cryotherapy (freezing)
- Intralesional injections (Vinblastine)
- Topical gel or cream (Panretin)
- Radiation
- Interferon
- Chemotherapy—adriamycin, vincristine, bleomycin, etoposide,
and paclitaxel
- Daunoxome (liposomal daunorubicin) or Doxil (lipsomal doxorubicin)
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