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Kaposi's sarcoma

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Kaposi's sarcoma

Definition
Kaposi's sarcoma is a specific type of cancer that involves the tissues of the skin or the coverings of blood vessels.

What is going on in the body?
Kaposi's sarcoma, or KS, usually begins in certain skin cells. These cells undergo cancerous changes and begin to grow uncontrollably. For people with intact immune systems, the cancer grows slowly, if at all, and rarely spreads. The disease becomes very aggressive if the person has an impaired immune system. HIV infections and drugs given after organ transplant will suppress the immune system. Until AIDS became widespread, KS was rarely seen. KS is common in people with AIDS.

What are the signs and symptoms of the disease?
A person usually will find an abnormal growth on the skin or on the mucous membranes inside the mouth. Any area of the skin can be affected. The growth is usually discoloured. The growth may not cause any pain or discomfort. Inside the mouth or throat, it may be large enough to interfere with swallowing or breathing.

What are the causes and risks of the disease?
People with HIV infection are at very high risk for KS. After organ transplant, people are given powerful drugs to prevent rejection of the new organ. Those people are also at risk. KS is otherwise very rare, but may be seen in a lesser form in elderly men of Mediterranean origin.

What can be done to prevent the disease?
There is no known prevention other than avoiding HIV infection. For people at risk, it is important to find the KS early. This means skin areas and mouth should be regularly inspected by the person at risk and a doctor to find the lesions while they are still small.

How is the disease diagnosed?
If cancer is suspected, it must be confirmed by examining the abnormal tissue in the pathology laboratory. This can mean removing a piece of the tissue with a biopsy. Sometimes the whole tumour is removed, which is known as a resection. Additional studies such as specialised X-rays and blood tests may be performed to measure the extent of the disease, which is known as staging the disease.

What are the long-term effects of the disease?
If cancer is not successfully treated, it will spread in people with compromised immune systems. The spread of the cancer can destroy tissue around and press on other structures. If the cancer spreads to organs like the lungs, it will cause death.

What are the risks to others?
KS cannot be spread to others. If the person is infected by HIV, the infection may be spread to other if precautions are not taken to prevent it. The HIV infection places the person at risk.

What are the treatments for the disease?
Treatment for KS may involve chemotherapy, radiation, or immunotherapy. Occasionally, a combination of treatments is used. Effectively treating underlying AIDS, if present, is also important. The goal may be to control the cancer and reduce pressure from the tumour on other structures. KS is not likely to be cured.

What are the side effects of the treatments?
The side effects of treatment depend on the specific therapy. Generally, treatment is designed to control the cancer and relieve symptoms. If the person with KS also has other medical conditions such as AIDS or has undergone organ transplant, those conditions may affect the person's well-being. Every effort is made to minimise side effects and maintain quality of life.

What happens after treatment for the disease?
The person will be monitored closely for recurrence and progression.

How is the disease monitored?
The lesion will be observed for changes. All other skin areas will also be observed because new KS lesions can develop. If organs like the lungs are involved then X-rays will be used to follow the person's progress. The frequency will depend on the person's condition and the extent of the cancer.

Author: Miriam P. Rogers, EdD, RN, AOCN, CNS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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