Kaposi's Sarcoma

(KS, Multiple Idiopathic Hemorrhagic Sarcoma)

In this factsheet:
• The Facts on Kaposi's Sarcoma
• Causes of Kaposi's Sarcoma
• Symptoms and Complications of Kaposi's Sarcoma
• Diagnosing Kaposi's Sarcoma
• Treating and Preventing Kaposi's Sarcoma

Diagnosing Kaposi's Sarcoma

The lesions associated with Kaposi's sarcoma can often be mistaken for other disorders, such as benign fungal infections or another type of cancer, non-Hodgkin's lymphoma. For that reason, your doctor will need to take a thorough medical history, asking questions about lifestyle and sexuality. He or she may recommend you have a test for HIV. After a physical exam, a skin biopsy is usually done.

A punch biopsy takes a small piece of tissue, while an excisional biopsy will remove the whole lesion. If many lesions are present, several of these might be tested just to verify that they are all the same. The excisional biopsy is usually performed if there are only one or two small lesions.

Other tests might include:

• an oral exam, to check for lesions on the palate, tongue, gums, or tonsils
• a rectal exam, to check for lesions in the anus
• endoscopy, done with a flexible tube (affixed with a tiny light and a camera) that looks at the linings of the esophagus and stomach
• a barium enema, which allows doctors to track the progress of barium through the colon by using X-rays
• sigmoidoscopy, which involves using an endoscope or sigmoidscope to view the lining of the rectum and colon
• chest X-rays, to check for lung lesions
• computed tomography (CT) imaging, which looks for lesions or other abnormalities
• bronchoscopy, which uses a thin tube used to look inside the lungs
• lung biopsy - if bronchoscopy shows lesions in the lungs, your doctor can take a sample for microscopic examination

Treating and Preventing Kaposi's Sarcoma

Treatment of Kaposi's sarcoma can be difficult due to the immunosuppressed state of many of the people who are affected: these people are at a high risk of infections from procedures. Your doctor will recommend treatment based on your general health as well as on where and how extensive the lesions are and how many there are. Generally, most cancers are treated by physical removal of the tumour or lesion (cryotherapy in this case), chemotherapy, radiation, or a combination. For people with AIDS, anti-HIV medications are used against the virus. This can improve the person's overall health and help treat Kaposi's sarcoma.

For skin lesions, some possible treatments are:

Cryotherapy:
Cryotherapy is a procedure that uses liquid nitrogen or other cryogens to freeze tissue. In cases of Kaposi's sarcoma, a doctor might freeze the lesions to destroy them.

Locoregional therapy:
Locoregional therapy involves injecting chemotherapy agents directly into the Kaposi's sarcoma lesions.

Radiation therapy:
Direct radiation therapy is another option to treat for the lesions. This involves aiming radiation directly at the spots. Some side effects associated with radiation include:

• fatigue
• red, dry skin at the radiation site
• nausea and vomiting
• decreased appetite
• diarrhea

If the Kaposi's sarcoma has advanced and affects the internal organs, other therapies might include:

Interferon:
Some success has been found using high-dose interferon. It can shrink tumour size in about 40% to 45% of cases. The use is limited to certain people, however, because it's a very toxic treatment.

Chemotherapy:
Like many cancers, chemotherapy is an option in treating Kaposi's sarcoma. Because this treatment is systemic (i.e., it affects many systems in the body) or generalized, many side effects can occur. Most chemotherapy medications are given by intravenous drip (IV), but some can be taken by mouth. Some common side effects of chemotherapy include:

• nausea and vomiting
• hair loss
• fatigue
• diarrhea
• chills
• shortness of breath
• coughing
• mouth sores

The latest research suggests that Kaposi's sarcoma may actually be not a cancer but a sexually transmitted virus. If this is the case, then the precautions taken against other sexually transmitted diseases should also be taken to try to prevent Kaposi's sarcoma. Practicing safe sex can also protect you from becoming infected with HIV, the virus that causes AIDS. Since AIDS increases the risk of Kaposi's sarcoma, practicing safe sex can help reduce your risk of this cancer.

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