The Facts About Kaposi's Sarcoma

The Facts About Kaposi's Sarcoma
HIV and Kaposis Sarcoma - An AIDS Defining Combination
Updated: July 13, 2007
By Mark Cichocki, R.N.,
About.com

At the beginning of the epidemic, Kaposis Sarcoma was the face of HIV. HIV infected people had what many referred to as the "AIDS look" Part of that look was the small darkened lesions scattered on the skin known as Kaposis Sarcoma. In the movie Philadelphia, Tom Hank's character was thin, drawn, with dark lesions which he tried to hide. HIV and Kaposis Sarcoma became synonymous with death, becoming known as the "gay man's cancer". Today KS is much less common but it can cause a problem in HIV infected people.
A Picture of Kaposis Sarcoma

What is KS?
KS is a lesion that primarily affects the skin but can affect internal organs and the lining of the mouth as well. When it is located on the skin, KS presents as small bruise-like areas that are not painful and do not itch. In fact, they are often mistaken for simple bruises. KS appears about eight times more often in gay men than in women. If isolated to the skin, KS is not life threatening. However, if KS forms in the intestinal track, lungs, brain or other internal organs, it can have serious consequences and can even be fatal.

What Causes KS?
The exact cause of KS is not entirely understood. Early on, it was thought that KS was a form of cancer. However, scientists now believe it is caused by the herpes virus HHV8. And since HHV8 can be transmitted via sexual contact, the risk of developing KS is thought to be spread from person to person as well. The health of a person's immune system appears to have some affect on whether KS will develop. In fact, KS has also been identified in HIV negative organ transplant patients who were receiving immunosuppressive therapy. The good news is that while KS is common, the incidence seems to be decreasing.
KS - An AIDS Defining Infection - What Are the Others?

Do I have KS?
KS lesions on the skin or in the mouth appear as discolored, darkened areas. They usually are not painful and do not itch. Their bruise-like appearance sometimes make them difficult to identify. An easy test to differentiate a KS lesion from a bruise is to press the area with one finger. A bruise's dark color will go away with finger pressure but a KS lesion's will not. However, the only way to absolutely diagnose KS is to perform a biopsy of the lesion. A small sample of the area is removed and examined under microscope. Any lesion on the skin that appears suspicious needs to be examined by a physician as soon as possible.
Important Fact!
Under no circumstance should you try to diagnose any skin lesion on your own. Any new or changing skin lesion should be examined by a doctor as soon as possible.

How Does KS Present?
KS that affects the internal organs may present in several ways.
KS of the Intestinal Tract
abdominal pain
diarrhea
intestinal obstruction

KS of the Lymph System
swelling in the legs or arms

KS of the Lungs
cough
chest pain
shortness of breath
difficulty breathing
extremity swelling
a pulmonary blockageg

Can KS Be Treated?
Several treatments are available for KS. However, if the KS lesions are confined to the skin treatment may not be necessary. However, KS lesions that involve large areas of the skin or internal organs, treatment is recommended. Those treatments include:

Skin lesions

Topical medications
surgical removal
chemotherapy drugs
freezing with liquid nitrogen
In advanced cases where KS has affected internal organs, several treatments have proven effective in shrinking the lesion.

Chemotherapy
Anti-cancer chemotherapy agents have been used to treat and shrink KS lesions that have affected internal organs. Like cancer therapies, these drugs often have unpleasant side effects such as nausea, vomiting and hair loss. And even more troubling is that these drugs can have damaging affects on the heart and bone marrow, resulting in a decrease in the number of white blood cells, furthering the risk of acquiring opportunistic infections.

Liposomal Drugs
Liposomal drugs are similar to chemotherapy drugs with one exception. These drugs are incased in microscopic fat bubbles which seem to lessen the adverse side effects. Studies have shown that these forms of drugs last longer and are able to move to the KS affected areas better.

What can I do to Prevent KS?
Unfortunately, not enough is understood about KS to totally prevent its development. However, the fact that the HHV8 virus has been implicated in KS suggests that preventing sexual transmission of the virus may decrease the risk of acquiring KS. In fact some studies suggest that the declines in KS may be a result in part to safer sex practices among gay men.
Preventing Sexual Transmission

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