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Is chemo always a must if K.S. found in node?
Mar 1, 2001

Dr. Dezube, thanks so much for your committment to helping people like myself. I've been HIV+ for 16 years...I'm 38... My CD4 cells are 350, my viral load is 30,000. I'm not on any meds (yet). I'm in very good health aside from chronic sinusitis and a wart condition that cleared up a while ago. A surgeon just removed a golf ball-sized lymph node from my groin (the first of its kind) to do a biopsy. The report is not back but he thinks it's K.S. (I have never had a skin lesion before.) I assume you will suggest I get on meds immediately. This I will definitely do if it is K.S. My big question (assuming it is K.S.): Is it absolutely necessary for me to do the internal chemo regimen based on what I've told you or might the meds alone help bolster my system enough to keep this from recurring? Also, is there a way to tell if this is the only K.S. outbreak in my body to help make a more informed decision? Obviously I want to avoid the chemo treatment if at all possible. Thanks so much for your time.

Response from Dr. Dezube

Hopefully by the time you get this response you'll know whether indeed you have KS of the lymph node. There's really no way for a surgeon to know that the lymph node is due to KS. The pathologist is really the only one who knows for sure. My suspicion is that it is NOT KS given your CD4 count of 350 and the absence of KS on the skin. HOWEVER, if it is KS, the most important thing for you to do is to begin HIV therapy (HAART therapy). This is often all you'll need. If the lymph nodes are unusually large or bothersome, then I often add in a few rounds (4 to 6) of chemotherapy to control the KS, while the HIV drugs begin to take hold. Two chemotherapeutic agents (DaunoXome and Doxil) are available in liposomal form, a homing mechanism by which the agents target directly the KS lesions, they don't cause hair loss or harm your immune system. Often you'll do better by NOT avoiding them. So to answer your "big" question of whether or not you need chemo, the answer is "not necessarily so, but perhaps". Hope this helps. BD.


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