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 interfere with 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 limit the occurrence of cancer. Because those living with HIV (HIV+) have weakened immune systems, HIV+ people are more vulnerable to several kinds of cancer. HIV+ people 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-Hodgkins and Hodgkins lymphomas
• Hepatitis B and Hepatitis C viruses: these can cause liver cancer
• Human herpesvirus 8 (HHV-8) or Kaposi's sarcoma herpesvirus (KSHV), 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 HIV+ people 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, but is less common in all people with HIV since the use of potent HIV drug combinations.

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. 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 around lesions (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)
• Skin treatment with cryotherapy (freezing) or Panretin (alitretinoin gel) if there are only a few lesions
• Injection into the lesion(s) with interferon or vinblastine
• Radiation therapy to the lesions, especially if lesions or tumor are bulky or have ulcers
• Oral or IV (inside the veins) chemotherapy drugs -- used for more widespread or internal KS