Cancers

Table of Contents

• What Is Cancer?
• Kaposi's Sarcoma (KS)
• Lymphoma
• Cervical Cancer
• Anal Cancer
• Liver Cancer
• Lung Cancer
• Conclusion

What Is Cancer?

Cancer refers to the abnormal and uncontrolled growth of certain cells that can get in the way of normal body functions. Cancer can spread (metastasize) from where it starts growing to other organs and parts of the body. Cancer can destroy healthy cells and cause illness and death.

A healthy immune system helps to prevent cancer. Because those living with HIV (HIV+) have weakened immune systems, it is easier for people living with HIV to become ill with several kinds of cancer. People living with HIV are more likely to be infected with viruses that can lead to cancer. These viruses include:

• Human papilloma virus (HPV): there are several types of HPV; certain types can cause cervical and anal cancer, as well as vaginal, vulvar, penile, and head and neck cancers
• Epstein Barr Virus (EBV): EBV can cause both non-Hodgkin's and Hodgkin's lymphomas
• Hepatitis B and Hepatitis C viruses: these can cause liver cancer
• Human herpesvirus 8 (HHV-8), which can cause Kaposi's sarcoma

The following types of cancer lead to an AIDS diagnosis: Kaposi's sarcoma, certain types of lymphoma, and cervical cancer. Other non-AIDS defining cancers for which people living with HIV are at increased risk include anal, liver, and lung cancer. All of these are explained in detail below.

Kaposi's Sarcoma (KS)

KS was one of the most common opportunistic infections (OIs) in the early days of the AIDS epidemic.

HHV-8 is the virus that causes KS. It is transmitted through sexual contact or blood products. KS has always been less common in women than in men, but is less common in all people with HIV since the use of newer, more effective HIV drug combinations.

A recent study found that some people living with HIV who have KS find that their KS gets worse after starting HIV drugs. This is most likely due to IRIS (immune reconstitution inflammation syndrome), which happens when your immune system acts so strongly and so quickly that it causes lots of inflammation that can actually make your symptoms worse. KS-IRIS usually happens more often in people living with HIV who have higher HIV viral loads, higher KS viral loads, and more advanced KS disease.

KS on the skin is not life threatening. However, if KS spreads to other parts of the body, especially the lungs, it can cause serious problems. An oncologist (a doctor who specializes in cancer) usually suggests treatment options based on factors such as the size, number, and location of KS tumors. However, the first treatment for KS is to begin HIV drugs. Your HIV provider and other specialists (e.g., radiation oncologist, dermatologist) may be involved as well.

Symptoms (by location)

• Skin (most common site of KS):
  • Flat or raised, and usually painless lesions that do not itch or drain
  • Lesions may be pink, red, purple, or brown -- or resemble "blood blisters"
  • There may be swelling, especially in the legs (lymphedema)
• Oral cavity (inside the mouth):
  • Lesions as described above
  • Trouble eating and swallowing
• Gastrointestinal tract tumors:
  • Diarrhea (loose or frequent stools)
  • Cramping
  • Bleeding
• Lung tumors:
  • Breathing problems
  • Bad cough

Diagnosis

• Usually made by biopsy (sample of tissue taken and examined under microscope)

Treatment

• HIV drug therapy alone may make lesions or tumors shrink or disappear (go into remission)
• Depending on the location of the KS, cancer specialists will recommend some combination of chemotherapy and radiation therapy