Fact Sheet Number 507
- WHAT IS KS?
- HOW IS KS TREATED?
- CAN KS BE PREVENTED?
- WHAT ELSE IS BEING STUDIED FOR KS?
- THE BOTTOM LINE
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PrintKaposi’s sarcoma (KS) is a cancer-like disease. It
usually shows up in the skin, or in the linings of the mouth,
nose, or eye. KS can also spread to the lungs, liver, stomach
and intestines, and lymph nodes. KS involves the development
of many new, tiny blood vessels. This process is called angiogenesis.
KS is caused by a herpes virus called Human Herpes Virus 8 (HHV-8).
KS affects about 20% of people with AIDS. In the US, the rate
of KS dropped by about 70% after the introduction of strong antiviral
medications.
KS is mostly a disease of men: there are about 8 men with KS
for each woman. It is one of the most visible signs of AIDS,
because it usually shows up as spots on the skin (lesions) that
look red or purple on white skin, and bluish, brownish or black
on dark skin. Lesions often occur on the face, arms and legs.
KS on the skin is not life threatening. If it spreads to other
places, KS tumors can cause serious problems. In the mouth lining,
it can cause trouble eating and swallowing. In the stomach or
gut, it can cause internal bleeding and blockages. In the lungs,
it can cause a serious cough or shortness of breath. If KS blocks
lymph nodes, it can cause severe swelling of the arms, legs, face,
or scrotum. KS in the lungs or internal organs can be life threatening.
KS can often be diagnosed by looking at the skin lesions.
They are usually flat, painless, and do not itch or drain. They
can look like a bruise, but a bruise will lose its purple color
if you push on it; a KS lesion won’t. KS lesions can grow into
raised bumps or patches and grow together. Your doctor might
take a small sample (a biopsy) from skin spots to examine under
a microscope and confirm a diagnosis of KS.
Highly active antiretroviral therapy (HAART) helps
treat active KS. In addition to HAART, there are different treatments
for KS in the skin or in other parts of the body.
In the skin, KS does not have to be treated if there
are only a few lesions. KS in the skin may come back after treatment.
Skin lesions can be:
- Frozen with liquid nitrogen,
- Treated with radiation,
- Cut out surgically,
- Injected with anti-cancer drugs or interferon alpha.
- Treated with Panretin gel (retinoic acid)
Other skin treatments being studied include SnET2, a drug that
is activated by exposure to light.
If KS has spread into internal organs, systemic (whole-body)
drug treatment is used. The standard treatment for advanced KS
is a combination of anti-cancer drugs referred to as “ABV”:
adriamycin, bleomycin, and vincristine. These drugs are given
intravenously, every 2 weeks.
This chemotherapy can damage the heart and the bone marrow,
causing a drop in the number of white blood cells. This condition
(neutropenia) makes it easier to get infections. Other side effects
include nerve damage in feet, legs, and hands, hair loss, and
nausea.
Other drugs used to treat KS include paclitaxel (Taxol®),
Doxil® and DaunoXome®. Doxil and DaunoXome are liposomal
forms of the anti-cancer drugs: doxorubicin and daunorubicin.
“Liposomal” means that tiny amounts of drug are encased
in small fat bubbles (liposomes). The drugs last longer in this
form and seem to move to the areas where they’re needed. Side
effects are reduced with liposomal forms of drugs.
There is no known way to prevent KS. HHV-8 is spread
through sexual activity, but probably also through deep kissing.
As with other opportunistic infections, a healthy immune system
can control HHV-8 infection.
BEING STUDIED FOR KS?
Anti-cytokine approaches: There is a lot of research
on cytokines, proteins that the immune system uses to stimulate
cells to grow. Researchers think that substances that can inhibit
these (and similar) growth factors can also slow down the growth
of KS.
Anti-HHV-8 drugs: Acyclovir was tried, but does not
work. However, other antiviral drugs, including ganciclovir,
cidofovir, lobucavir and foscarnet are being studied.
Anti-angiogenesis drugs: Interferon alpha and several
other compounds are being studied. These include SP-PG, fumagillin,
thalidomide, angiostatin, TNP-470, IM862, and endostatin.
KS is a disease that affects about 20% of people with
AIDS. It is caused by a herpes virus called HHV-8.
KS in the skin can be treated in several ways and is not a
serious problem. KS in internal organs can be life threatening.
Internal KS is usually treated with anti-cancer drugs.
If you notice new dark spots on your skin, have your doctor look
at them to see if you might have KS.
Revised December 21, 2000
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