What is Kaposi’s sarcoma?
Kaposi’s sarcoma (KS) is a disease in which cancer (malignant) cells are found in the tissues under the skin or mucous membranes that line the mouth, nose, and anus. KS causes red or purple patches (lesions) on the skin and/or mucous membranes and spreads to other organs in the body, such as the lungs, liver, or intestinal tract.
Until the early 1980’s, Kaposi’s sarcoma was a very rare disease that was found mainly in older men, patients who had organ transplants, or African men. With the Acquired Immunodeficiency Syndrome (AIDS) epidemic in the early 1980’s, doctors began to notice more cases of Kaposi’s sarcoma in Africa and in gay men with AIDS. Kaposi’s sarcoma usually spreads more quickly in these patients.
If there are signs of KS, a doctor will examine the skin and lymph nodes carefully (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells). The doctor also may order other tests to see if the patient has other diseases.
The chance of recovery (prognosis) depends on what type of Kaposi’s sarcoma the patient has, the patient’s age and general health, and whether or not the patient has AIDS.
Stages of Kaposi’s sarcoma
There is no accepted staging system for Kaposi’s sarcoma. Patients are grouped depending on which type of Kaposi’s sarcoma they have. There are three types of Kaposi’s sarcoma:
Classic Kaposi’s sarcoma usually occurs in older men of Jewish, Italian, or Mediterranean heritage. This type of Kaposi’s sarcoma progresses slowly, sometimes over 10 to 15 years. As the disease gets worse, the lower legs may swell and the blood may not be able to flow properly. After some time, the disease may spread to other organs. Many patients with classic Kaposi’s sarcoma may develop another type of cancer later on in their lives.
Immunosuppressive treatment related
Kaposi’s sarcoma may occur in people who are taking drugs to make their immune systems weaker (immunosuppressants). The immune system helps the body fight off infection. People who have had an organtransplant (such as a liver or kidney transplant) have to take drugs to prevent their immune system from attacking the new organ.
Kaposi’s sarcoma in patients who have Acquired Immunodeficiency Syndrome (AIDS) is called epidemic Kaposi’s sarcoma. AIDS is caused by a virus called the Human Immunodeficiency Virus (HIV), which attacks and weakens the immune system. Infections and other diseases can then invade the body, and the immune system cannot fight against them. Kaposi’s sarcoma in people with AIDS usually spreads more quickly than other kinds of Kaposi’s sarcoma and often is found in many parts of the body.
Recurrent disease means that the Kaposi's sarcoma has come back (recurred) after it has been treated. It may come back in the area where it first started or in another part of the body.
Treatment Option Overview
How Kaposi’s sarcoma is treated
There are treatments for all patients with Kaposi’s sarcoma. Four kinds of treatment are used:
Surgery (taking out the cancer).
Chemotherapy (using drugs to kill cancer cells).
Radiation therapy (using high-dosex-rays to kill cancer cells).
Biological therapy (using the body’s immune system to fight cancer).
Radiation therapy is a common treatment of Kaposi’s sarcoma. Radiation therapy uses high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation for Kaposi’s sarcoma comes from a machine outside the body (external-beam radiation therapy).
Surgery means taking out the cancer. A doctor may remove the cancer using one of the following:
Localexcision cuts out the lesion and some of the tissue around it.
Electrodesiccation and curettage burns the lesion and removes it with a sharp instrument.
Cryotherapy freezes the tumor and kills it.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the original site. Chemotherapy for Kaposi’s sarcoma also may be injected into the lesion (intralesional chemotherapy).
Biological therapy tries to get the body to fight the cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body’s natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.
For the treatment of epidemic Kaposi's sarcoma, a type of biological therapy called highly active antiretroviral therapy (HAART) is used alone, or with other therapies. HAART combines several antiretroviral drugs that target HIV (which is a retrovirus). These drugs help block the virus from multiplying in the body and lower the risk of epidemic Kaposi's sarcoma.
Treatment by Stage
Treatment of Kaposi’s sarcoma depends on the type of Kaposi’s sarcoma the patient has, and the patient’s age and general health.
Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of Kaposi’s sarcoma. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.