Kaposi’s sarcoma By Debbie King Kaposi’s sarcoma (KS) is a vascular malignant tumor caused by human herpesvirus 8 (HHV-8) and often associated with AIDS. This disease causes lesions to grow under the skin, in the mouth, gastrointestinal tract and the respiratory tract. These lesions can be purple, pink to reddish-brown or bluish (somewhat similar to a bruise) and usually papular/raised. KS is generally not considered a true sarcoma as it starts as a cancer of the lymphatic endothelium and forms vascular channels that fill blood cells.
There are varies types of KS which are listed below. • Classic KS: affects elderly men in the Mediterranean region or of Eastern European descent. Most commonly appears early on toes and soles or feet. • Immunosuppression associated KS: similar to Classic KS with the sites presenting in various areas. • Endemic/African KS: found in young adult males (most common in 20 yrs to 50 yrs of age) in Africa, mostly living near the Equator. This is a more aggressive type that infiltrates the skin especially on the lower limbs. African KS in unrelated to HIV infection.
Appears as nodular, infiltrative, vascular masses on the extremities. Rarely found in African women. • African lymphadenopathic KS: Found in young children under the age of 10 yrs. Very aggressive, lymph node involvement and can be with or without lesions. • Transplant KS: Very rare that KS could be transplanted until the use of T-cell inhibitors such as calcineurin. There are 2 ways that of transplanting: 1. When an HHV-8 infected organ is transplanted to someone that had not been exposed to the virus or 2. When a patient that has a pre-existing HHV-8 infection. AIDS associated KS: In 1980 KS was reported the most aggressive in AIDS patients. Three hundred times more common in AIDS patients than in renal transplants. Presents with cutaneous lesions that can be one or many, rapidly progresses to papules, nodules and plaques. Shows on head, neck, trunk and mucous membranes. Some of the signs and symptoms of KS are as follows: • Tumors appear as bluish-red or purple sores/lesions on all areas of the body. • Bleeding from the gastrointestinal lesions. • Bloody sputum for the lungs. Shortness of breath and coughing from the lungs. • Leg swelling from the lymph nodes of the legs. Prior to the AIDS epidemic KS was seen in elderly Italian and Jewish men where the tumors grew slowly. There is a higher risk for those living close to the equator and people that have kidney or other organs transplants. In 1980’s the AIDS epidemic cause was linked by the interaction of HIV, a weakened immune system and HHV-8. HIV and HHV-8 is sexually transmitted among those who are at risk for sexually transmitted HIV infection especially among men having sex with men.
Methods of detection for KS are: • Bronchoscopy • CT scan • Endoscopy • Skin lesion biopsy • HIV blood tests Treatment can vary depending upon how much of the immune system is suppressed, the number and location of the lesions and the symptoms. Treatments are: • Antiviral therapy for the AIDS virus • Chemotherapy • Radiation • Cryotherapy. Unfortunately the lesions and tumors may return after the treatment. Kaposi’s sarcoma is not curable but can be controlled for many years with treatments.
There is no chance of survival for AIDS patients. The life expectancy will vary upon the immune system and how much of the HIV virus is in the blood. It appears that Kaposi’s sarcoma is a rapidly spreading disease in the majority of different types. Massage is contraindicated with Kaposi’s sarcoma. Open lesions on the skin and internal organs are very sensitive and any type of pressure could create more pain. Complications could arise internally that you would not be aware of and open sores should never be touched.