Custom Search by Tirgan.com

Home    Content    services

Kaposi's Sarcoma (KS)

Kaposi's Sarcoma is the most common malignancy associated with HIV infection, occurring in roughly 20 percent of infected patients. It is more frequent in men than in women.

Signs and Symptoms

The patient may notice a purple-colored skin lesion on his/her skin or inside the mouth. KS can involve the bowels. Some AIDS patients present with severe bleeding from the bowels. It may also involve the lungs and present with shortness of breath.

Establishing Diagnosis

When the diagnosis is suspected, patients should be examined carefully by a qualified physician. Suspicious lesions should be biopsied and evaluated. A chest x-ray and study of a sample of sputum are important first steps in making a diagnosis of KS in the lungs, followed by a Bronchoscopy and biopsy. In some patients, the cancer may have already spread to lymph glands in the neck. In such cases, a fine needle aspiration of the node should be performed. This a fairly simple procedure. This test is crucial as it establishes a diagnosis in about 30 percent of patients. In a small percentage of patients, none of the above tests will lead to a diagnosis; therefore, there is a need to proceed with more invasive procedures, or even surgery. Endoscopy can establish the diagnosis of bowel KS.

Staging Work-Up

Once a diagnosis of Kaposi's Sarcoma is established, the patient must be thoroughly examined to determine crucial information. A CT scan of the chest and abdomen and a bone scan should be performed to determine the extent of the spread. The purpose of these tests is to observe the tissues and organs where cancer has a tendency to spread.

Patterns of spread

Kaposi's Sarcoma can either spread locally and involve nearby tissues, i.e., spread to the cavity outside the lungs (pleural space) and layers around the heart, or travel to distant sites such as local lymph glands or the liver, bones, brain, or the opposite lung. Other organs where Kaposi's Sarcoma has a tendency to spread are the Adrenal glands, which are the glands located above the kidneys. These glands produce special hormones. Another area where the cancer may spread is the area near the spinal cord and vertebrae.

Treatment:

Appropriate treatment is determined by the extent of KS. Small skin lesions can be treated with topical medication, Cryotherapy or surgery. Interferon and Chemotherapy may be used in more advanced cases. Vincristine, Adriamycin, and VP-16 are among the most active drugs.

Special Situations

Patients with advanced Kaposi's Sarcoma may develop any of the following complications:

• Pleural effusion

• Pericardial effusion

• Brain metastasis

• Bone metastasis

• Pain

Survival

Survival of patients with Kaposi's Sarcoma will depend on the type and extent of the cancer at the time of the initial diagnosis, as well as the severity of AIDS and its response to treatment.

Follow-up

After completion of treatment, in any combination that might have taken place, patients need to remain under surveillance for a possibility of recurrence of cancer. Follow-up should be scheduled on a regular basis, initially every one to three months for one to two years. The frequency of follow-up will depend upon the condition of the patient and his/her disease. In each follow-up visit, patients are examined and normally a chest x-ray is performed every few months.

Treatment of the recurrent disease will depend on the stage and extent of the reoccurred disease. Most patients are treated with chemotherapy, with the agents mentioned above. Radiation therapy may be helpful in managing painful or symptomatic areas to which the cancer has spread. If patients experience pain, various pain medications may be used to alleviate pain. For patients with advanced disease, where most treatments have failed, one could consider assistance from Hospice.