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Ask the Experts about AIDS-Related Cancers

 

How likely: KS in my prostate?
Feb 21, 2003

I am 69 years old without any health problem other than HIV and KS. I was diagnosed with HIV 1 1/2 yrs ago. I had 415 CD4 cells and VL of 8,000, but I also had a KS lesion on my ankle. I was put on Combivir and Viramune and I became undetectable in a few weeks and remained so and my CD4 cell count has been mostly in the 500s. Part of the lesion was excised,but an area next to it was not. Another small KS lesion appeared 3/4" away after 8 months and that was excised. I started on radiation for that portion of the original KS that never cleared up on its own, last month and just before that a lesion of about the size of 2 pinheads appeared, in the same ankle area, but it never was raised. The radiation has cleared up some but not all, but I was told to wait 4-5 weeks for the maximal effect of the radiation. Here's the worry/question: the urologis found an area on my prostate that was a little enlarged and had the feel of being like a small stone-he could kinda roll it. There were several of them. My PSA was very normal (0.1) I will be biopsied. My fear is that it may be KS! Considering all I related to you, including the fact that the KS has been confined to the outer part of the rt ankle (within about a 3" X 2" area) how likely is it that it is KS? Thank you so much! AND KEEP UP YOU WONDERFUL WORK! WE SO APPRECIATE IT!

Response from Dr. Dezube

Kaposi's sarcoma in the prostate is most unusual! It has indeed been reported to occur. However, I have personally never seen a case. (This is despite the fact that I have been seeing HIV patients since the start of the epidemic in the early 1980s; that's alot of HIV cases.) I'm glad to hear that you are going to be biopsied--- that indeed is the logical next step. An additional reassurance to you appeared in a New England Journal of Medicine article. In that article, researchers checked prostatic secretions to see how often human herpesvirus-8 (HHV-8) was present there. Their research showed that HHV-8 invovlement of the prostate is quite rare. HHV-8 is the virus that causes Kaposi's sarcoma.

Please write back and let me know what your biopsy showed.



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