by Alan R
(KS)

Definition

Kaposi's sarcoma (KS) is a form of cancer. It can cause lesions on the skin, mucus membranes, or internal organs such as the gastrointestinal tract and lungs.

KS can be classified according to the group of people it affects:

  • Classic—usually affects men of Mediterranean descent
  • Endemic—usually affects people living in equatorial Africa
  • Transplant-related (acquired)—affects people who have received an organ transplant and have a suppressed immune system
  • AIDS-related (epidemic)—affects people who have HIV infection

Causes

Cancer occurs when cells in the body divide without control or order. If cells keep dividing, a mass of tissue forms. This mass is called a growth or tumor. Malignant tumors can invade and destroy nearby tissue. Some types of cancer will eventually spread to other parts of the body.

KS is caused by an infection with a specific virus. The virus is called human herpes virus 8 or Kaposi sarcoma herpesvirus (KSHV). Most people infected with the virus will not get KS. KS most often develops in people who have the virus and also have a weakened immune system.

Risk Factors

Factors that may increase the chances of KS:

  • Having HIV infection
  • Using medication that suppresses the immune system

Symptoms

KS lesions may develop anywhere on the body. They tend to be raised blotches or nodules which may be purple, brown, red, or pink.

Skin Lesions
Skin Lesions
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Lesions in the lungs can also cause breathing problems.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be will be done If you have skin lesions, the doctor may base the diagnosis on this. If you have bleeding, pain, or weight loss, you may need more tests to find out if you have KS.

Tests may include:

Treatment

Talk to your doctor about the best treatment plan for you. Treatment depends on the type of KS, how much it has spread, and how well a person's immune system is functioning. Treatments include one or more of the following:

Local Therapy

Local therapy is useful if there are a few lesions together in a small area. Treatments options may include:

  • Topical retinoid gel—Applied directly to the lesion. It shrinks the lesion over the course of 1-2 months.
  • Cryosurgery—Liquid nitrogen is used to freeze and kill the abnormal cells. After the area thaws, the dead tissue falls off. More than one freezing may be needed to remove the growth completely.

These treatments do not prevent new lesions from developing.

Surgery

Surgery is an option if there are a few, small lesions. Surgical options include either:

  • A simple excision—A surgical knife is used to cut the lesion out.
  • Curettage and electrodesiccation—A curette is an instrument with a sharp, spoon-shaped end. It is used to scoop out the affected area. A small electric current will help to control bleeding. It will also kill any cancer cells remaining around the edge of the wound.

Photodynamic Therapy

Photodynamic therapy is a type of light therapy. A special medication is applied to the skin to make it sensitive to light. The skin is later exposed to a special light. The sensitivity to the light kills the cancer cells.

Radiation Therapy

High-energy radiation is used to kill cancer cells. The number of treatments depends on the size and location of the lesions. It can also be used to treat pain and swelling. Different types of radiation therapy may include:

  • Electron-beam—Shallow penetration used to treat skin lesions
  • Photon—Deeper penetration used to treat mouth or throat lesions

Radiation therapy schedules may vary, but it is generally done over a period of several weeks.

Antiretroviral Therapy

This therapy is used to treat HIV infection and restore immune function. In some, it may be effective against KS.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms, including pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells. Some healthy cells are also killed.

In some cases, the drugs can be injected directly into a lesion.

Immunotherapy

This is the use of drugs to enhance the body's own immune system. They are used to increase or restore the body's natural defenses against cancer. Immunotherapy of KS is done with interferon.

Prevention

There are no current guidelines to prevent KS.

RESOURCES

American Cancer Society  https://www.cancer.org 

National Cancer Institute  https://www.cancer.gov 

CANADIAN RESOURCES

Canadian AIDS Society  http://www.cdnaids.ca 

Canadian Cancer Society  http://www.cancer.ca 

References

Kaposi sarcoma. American Cancer Society website. Available at: https://www.cancer.org/cancer/kaposi-sarcoma.html. Accessed January 29, 2021.

Kaposi sarcoma. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T115224/Kaposi-sarcoma. Accessed January 29, 2021.

Kaposi sarcoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/soft-tissue-sarcoma/patient/kaposi-treatment-pdq. Accessed January 29, 2021.

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