Kaposi’s Sarcoma: Causes, Symptoms, Diagnosis, and Treatment

Kaposi’s sarcoma is a cancer that develops from cells through the lymph or blood vessels. This causes the growth of abnormal tissue in the skin, lymph nodes, internal organs, mucous membranes in the mouth, nose, and throat. Sarcoma often attacks people with immune diseases, such as HIV/AIDS.

Kaposi’s sarcoma usually appears as a tumor on the skin or a bump on the mucosal surface like a lump in the mouth, but the tumor can also develop in other parts of the body such as in the lymph nodes, lungs, or digestive tract.

Abnormal cells caused by sarcomas form purple, red, or brown patches on the skin. This affected area is called a lesion. Kaposi’s sarcoma skin lesions most commonly appear on the feet or face. These skin lesions can look bad, but usually do not cause symptoms. Some lesions on the feet or in the groin area can cause legs and feet to swell and pain.

Causes of Kaposi’s Sarcoma

Kaposi’s sarcoma is caused by the herpes virus HHV-8 or called Kaposi sarcoma-associated herpesvirus (KSHV). This virus is spread mainly through:

  • Saliva.
  • Sexual contact.
  • The relationship between mother and child.

A person with a good immune system can carry the virus without problems or without symptoms. However, it triggers cancer in people with weakened immune systems.

Sarcoma affects eight times more men than women. Among people who have HIV, men who have sex with men are more likely to have the virus and get sarcoma.

Kaposi’s Sarcoma and HIV

Because people with HIV have a weak immune system, they are more likely to develop certain cancers, including Kaposi’s sarcoma. Most severe cases occur when a person has AIDS, but skin lesions can appear earlier. This indicates that the immune system is not in full strength. Skin lesions tend to get worse when you also have other infections.

Risk Factors

The following are factors that can increase the risk of sarcoma:

  • Hereditary syndrome. The risk of soft tissue sarcoma can be inherited from parents. Genetic syndromes that increase risk such as hereditary retinoblastoma, Li-Fraumeni syndrome, familial adenomatous polyposis, neurofibromatosis, tuberous sclerosis, and Werner syndrome.
  • Chemical exposure. Exposed to certain chemicals such as herbicides, arsenic and dioxins, can increase the risk of soft tissue sarcoma.
  • Radiation exposure. Radiation treatment for other cancers can increase the risk of soft tissue sarcoma.

Types of Kaposi’s Sarcoma

There are four types of Kaposi’s sarcoma that you must know, including:

  • AIDS epidemic/related. This is the most common type in America and affects people who have HIV.
  • Classic. This type affects older men of Mediterranean, Middle Eastern, or Eastern European descent.
  • Endemic. Children and adolescents from Africa are more at risk of getting this type of Kaposi’s sarcoma.
  • Immunosuppressive. This type affects people who have organ transplants and take drugs that slow down their immune system.

Symptoms of Kaposi’s Sarcoma

The most visible signs of Kaposi’s sarcoma are lesions on the skin such as patches, non-protruding, painless, red or purple in people with white skin and bluish, brownish, or black spots on people with dark skin.

Unlike bruises, the patches do not turn white when you press them. The patches are not itchy, and are not runny. The spots are not life-threatening.

New patches can appear every week and for some people these lesions change slowly. These lesions can grow into lumps or small patches that converge into larger spots.

When sarcoma spreads to other places, the condition can be life threatening. You can experience:

  • Difficulty eating or swallowing.
  • Baldness, vomiting, abdominal pain due to bleeding and blockage in the stomach.
  • Severe swelling in the arms, legs, face, or scrotum.
  • Severe coughing or shortness of breath.

When is the Right Time to See a Doctor?

See a doctor immediately if you have:

  • Lumps that get bigger or become painful.
  • Lump located deep in the muscle.
  • Repetition of lumps that have been removed.

Diagnosis of Kaposi’s Sarcoma

Doctors can diagnose Kaposi’s sarcoma just by looking at the appearance of the skin. To confirm that, doctors can take tissue samples from somewhere and view them under a microscope. Other possible tests include:

This test is done to look for blood in the stool. In some cases, Kaposi’s sarcoma can injure the digestive tract.

  • Endoscopy or Colonoscopy

If you have stomach problems, your doctor may want to see the condition of the intestine with the help of special tubes called endoscopy and colonoscopy.

  • Bronchoscopy

If you have difficulty breathing, this procedure can be done. Bronchoscopy is a procedure that involves inserting a small, soft tube into the mouth or nose with the aim of looking into the respiratory tract.

  • Imaging Test

CT scan or X-ray can find out whether the cancer has spread to the lungs, lymph nodes, or other parts of your body.

Treatment of Kaposi’s Sarcoma

Treatment depends on how many lesions are owned and how large they are and where they are in the body, and how well the immune system works.

In many cases, an HIV drug called ART (antiretroviral therapy) is the best way to treat active Kaposi’s sarcoma. ART can also eliminate skin lesions.

If you have multiple spots due to Kaposi’s sarcoma, you can get rid of it. But removing blotches does not cure it because it only makes the skin look better. Doctors can cut tissue or freeze to remove it. In addition, radiation also kills cancer cells or prevents them from growing.

Meanwhile, if you have many lesions or viruses affecting many areas of the body, you might get radiation therapy. This method is useful to kill cancer cells or make it not grow.

If the sarcoma has spread, you need drugs that affect the whole body to kill cancer. Chemotherapy drugs for Kaposi’s sarcoma include:

  • Doxorubicin.
  • Paclitaxel.
  • Vinblastine.

Chemotherapy can have side effects, including hair loss, vomiting, and fatigue. If you are HIV-positive, you also need to consider that chemotherapy can reduce platelet and white blood cell levels, and increase the chance of infection.

Another type of medication, called biological therapy, works by boosting the immune system. Your doctor may prescribe interferon alpha (Intron A) if your CD4 cell count (immune cell type) is above 200 and has a reasonably healthy immune system.

Complications of Kaposi’s Sarcoma

The most common complications of sarcoma are secondary malignancy and secondary infections. In particular, secondary infections occur in groups of people with sarcoma who suffer from AIDS. Meanwhile, in patients with classic Kaposi sarcoma, lymphomas develop by about 35%, usually after a few years.

Kaposi’s sarcoma can produce clinical problems including edema (swelling in certain parts of the body) from disorders of the lymphatic system (sometimes causing pain), difficulty breathing, skin fragility, or localized skin infections. In other cases, when patients undergo antiretroviral therapy, immune reconstitution inflammatory syndrome is reported to be greater.

Prevention of Kaposi’s Sarcoma

Until now there is no drug that can protect the body from sarcoma. The best way to avoid this disease is to avoid things that put you at higher risk of HIV, such as unprotected sex or sharing needles. A drug called pre-exposure prophylaxis (PrEP) can also make you less likely to get HIV.

Meanwhile, if you already have HIV, further tests are needed to find out if you have HHV-8. Antiretroviral therapy reduces the risk of developing Kaposi’s sarcoma. If you have had an organ transplant, some anti-rejection drugs can also reduce your chances of getting Kaposi’s sarcoma.


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