Kaposi’s sarcoma (KS) is a cancerous tumor. It commonly appears in multiple locations on the skin and around the nose, mouth, genitals, and/or anus, but can also attack the internal organs. It’s caused by a virus called the human herpes virus 8 (HHV8).
According to the American Cancer Society, it is an “AIDS-defining” condition, meaning that when KS is present in a person who is HIV-positive, the person has developed AIDS (American Cancer Society, 2011).
However, just because someone has KS does not necessarily mean they have AIDS. KS can develop in an otherwise healthy person. For many years before AIDS was a worldwide disease, KS was a slowly progressive disorder and was not considered to be very serious.
Visible KS is a raised red or purple patch on the skin. You might at first mistake it for a bruise, then notice that the area of involvement is elevated. KS appears often on the face, around the nose or mouth, or around the genitals or anus.
KS can infect the lungs, liver, and intestines, in which case there are no visible signs. If your lungs or gastrointestinal organs are involved, you can experience bleeding. If the lungs are affected, shortness of breath can occur. Any of these symptoms should be reasons to seek medical attention.
There are several types of KS. These include:
AIDS-Associated Epidemic KS
- seen almost exclusively in men who are HIV-positive and who have had sex with other men
- appears first around the head and neck
- according to the American Cancer Society, the most common type of KS in the United States (Cancer, 2012)
- advances very rapidly, but is not always fatal
- seen most often in older men of Southern Mediterranean or Eastern European heritage
- appears first around the legs and feet
- progresses over many years and is not often fatal
African Cutaneous KS
- seen in men from tropical Africa
- can involve bones
- causes legs to swell
- is often fatal within two years
African Lymphadenopathic KS
- seen in young children from tropical Africa
- may or may not involve the skin
- is often fatal within two years
- seen in patients who have had kidney or other organ transplants
- related to medicines given to help the body accept a new organ
- resembles indolent KS
There’s a less common form of KS called gay-related KS. It is seen in men who are not HIV-positive, but who have sex with other men. Gay-related KS resembles indolent KS.
Even though it often progresses slowly, KS can ultimately be fatal, so it should always be treated.
The forms of KS appearing in men and young children who live in tropical Africa are the most serious. Left untreated, these forms can result in death in a few short years.
Because indolent KS appears in the elderly and takes many years to develop, many patients die of another condition before their KS becomes serious enough to be fatal.
Despite the fact that it is associated with AIDS, AIDS-related KS is most commonly treatable and not fatal.
A doctor can usually diagnose KS by a visual inspection and by asking some questions about your health history. But because other conditions might look similar to KS, a second test can be conducted. If there are no visible symptoms of KS, a second test will be necessary.
Testing for KS might be conducted any of the following ways:
A biopsy involves the removal of cells from the suspected site. This sample is then sent to a lab for testing.
An X-ray can be used to look for signs of KS in the lungs.
An endoscopy is a procedure for viewing inside of the upper gastrointestinal tract (g.i. tract)- esophagus and stomach. A long, thin tube with a camera and a biopsy tool on the end is used for viewing the inside of the g.i. tract and for taking biopsies or tissue samples. .
A bronchoscopy is an endoscopy of the lungs.
There are several ways of treating KS, including removal, chemotherapy, interferon (an anti-viral agent), and radiation. Your health care team will determine the best approach for treatment.
There are a few ways of surgically removing KS tumors, including:
- surgery - is only used on patients who have only a few small lesions
- cryotherapy to freeze and kill the tumor - has a good success rate
- electrodessication to burn and kill the tumor
These therapies treat only the individual lesions and can’t keep new lesions from developing.
Chemotherapy is used with caution since the immune system of these patients is so depressed due to the underlying disease. The most commonly used drug to treat KS is doxorubicin lipid complex (Doxil).
Interferon is a protein that naturally occurs in the human body. The medically developed version can be injected to help patients with KS if they have a healthy immune system.
Radiation is targeted, high-energy rays aimed at a particular part of the body. Radiation therapy is only of use in treating KS when the lesions are not spread over a large part of the body.
KS is curable with treatment, but if left untreated or if not treated fully, it can be fatal. That is why it is very important to get treatment right away.
Do not expose anyone to your lesions if you think you may have KS. See your doctor and begin treatment right away.
Don’t touch the lesions of anyone who has KS.
If you are HIV-positive, have had an organ transplant, or are otherwise more likely to develop KS, your doctor may suggest HAART, which stands for “highly active antiretroviral therapy.” HAART reduces the likelihood that HIV-positive people will develop KS and AIDS.