Kaposi's Sarcoma

Kaposi's sarcoma is a cancer of blood vessels that was considered very rare before the start of the AIDS pandemic. It is now the most frequent cancer to develop in people with AIDS, affecting about 20% overall. Initially, Kaposi's sarcoma of the lymphatic cell wall was described as a rare blood vessel sarcoma, occurring mostly in elderly Italian and Jewish men. In recent years, the incidence of Kaposi's sarcoma has risen dramatically along with the incidence of acquired immunodeficiency syndrome (AIDS). Currently, it's the most common AIDS-related cancer.

Characterized by obvious, colorful lesions, Kaposi's sarcoma causes structural and functional damage. When associated with AIDS, it progresses aggressively, involving the lymph nodes, the viscera, and possibly GI structures.

Causes

The exact cause of Kaposi's sarcoma is unknown, but the disease may be related to immunosuppression. Genetic or hereditary predisposition is also suspected.

Symptoms

• Bluish-red, flat or raised lesions with an irregular shape
• Bleeding from gastrointestinal lesions
• Shortness of breath from lesions in the lung
• Bloody sputum from lesions in the lung

Diagnostic tests 

The appearance of Kaposi's sarcoma lesions is often typical but a skin biopsy of a lesion allows a definite diagnosis.

Treatment

Radiation therapy, chemotherapy, and drug therapy with biological response modifiers are treatment options. Radiation therapy offers palliation of symptoms, including pain from obstructing lesions in the oral cavity, or extremities and edema caused by lymphatic blockage. It may also be used for cosmetic improvement.

Chemotherapy includes combinations of doxorubicin, vinblastine, vincristine, and etoposide (VP 16). The biological response modifier interferon alfa-2b may be prescribed in AIDS-related Kaposi's sarcoma. It reduces the number of skin lesions but is ineffective in advanced disease.

Prevention

Safe sexual practices can prevent infection with HIV, which in turn prevents the development of AIDS and its complications, including Kaposi's sarcoma. Treatment with antiretrovirals may help to preserve the function of the immune system in HIV patients and delay the appearance and progression of KS lesions.