Kaposi's Sarcoma

Kaposi's sarcoma is a cancer that produces multiple flat pink, brown, or purple patches or bumps on the skin; it is caused by herpesvirus type 8.

Kaposi's sarcoma occurs in several distinct groups of people and acts differently in each group. It occurs in older men, usually of Mediterranean or Jewish heritage; in children and young men from certain parts of Africa; in people receiving immunosuppressants after organ transplantation; and in people with AIDS (which accounts for most of the cases in the United States).

Symptoms

In older men, Kaposi's sarcoma usually appears as a single purple or dark brown spot on the toes or leg. The cancer may grow to several inches or more as a deeply colored, flat or slightly raised area that tends to bleed and break open. Several additional spots may appear on the leg, but the cancer rarely spreads to other parts of the body and is almost never fatal.

In the other groups, Kaposi's sarcoma is more aggressive. Similar appearing spots develop, but they are often multiple and may occur anywhere on the body. Within several months, the spots spread to other parts of the body, often including the mouth, where they cause pain with eating. They may also develop in lymph nodes and internal organs, especially the digestive tract, where they can cause diarrhea and internal bleeding that leads to blood in the stool.

Diagnosis and Treatment

Doctors usually recognize Kaposi's sarcoma by its appearance. A biopsy is usually performed to confirm the diagnosis.

Older men with slow-growing Kaposi's sarcoma in one or two spots may have the tumors removed surgically or by freezing. People with multiple spots usually receive radiation therapy. Some people with very few spots and no other symptoms may choose to receive no treatment unless the condition spreads.

People who have the more aggressive form, but whose immune system is normal, often respond to interferon-alpha or chemotherapy drugs.

In people taking immunosuppressants, the tumors sometimes disappear when immunosuppressants are discontinued. If these drugs must be continued because of the person's underlying condition, however, chemotherapy and radiation therapy are used. However, these treatment methods are less successful than in people with a healthy immune system.

In people with AIDS, treatment with chemotherapy and radiation has not been very successful. The best results are achieved in people whose immune system improves as a result of intensive treatment with AIDS drugs. In general, treating Kaposi's sarcoma does not appear to prolong the lives of people with AIDS.