The second most frequent tumour in HIV infected patients, Kaposi Sarcoma, is one of the most catastrophic illnesses that stroke humanity. In 1993 my life changed forever, when I was discovered to be full blown AIDS positive and a Dx of Kaposi Sarcoma, located inside my lower intestinal tract and rectum. At the beginning I was told there is no cure for the illness, after which I was offered a treatment based on chemotherapy and radiation every week for 8 months. There was no guarantee that the treatment will work; however, I was informed that if the cancer, KS, was not back five years after the treatment, then it was successful.
As a long term survivor, I am writing this essay about Kaposi Sarcoma; the nature of the illness, its causes, symptoms, and different types of treatments will be addressed. Furthermore, medical development in the last twenty years has found different ways in which the treatment in KS can be made less painful and easier to cope for the patient, something I wish I could have benefitted from when I was sick.
According to the National Cancer Institute and the National Institutes of Health, Kaposi Sarcoma is defined as:
A cancer that causes lesions (abnormal tissue) to grow under the skin, in the lining of the mouth, nose, and throat, or in other organs. The lesions are usually purple and are made of cancer cells, new blood vessels, and white blood cells. Kaposi sarcoma is different from other cancers in that lesions may begin in more than one place in the body at the same time.
It was found that all patients with KS have HHV-8 (Human Herpesvirus-8) in the lesions, though most HHV-8 infected do not have the illness. KS is developed only when the immune system of a patient is compromised due to different causes. Among these are HIV positive, people that have taken a medical treatment involving drugs that weaken the immune system, usually given after an organ transplant or another disease.
Thus, several types of KS can be found:
- Classic Kaposi Sarcoma – usually found in older men, Italian or Eastern- European Jewish origin; symptoms include red, purple, or brown skin lesions; they can form in different parts of the body, not only the skin; symptoms for lesions in the digestive tract can be bleeding.
- African Kaposi Sarcoma – found mainly in young men living closer to the equator, much more aggressive than the first type, though symptoms are the same; it can spread fast to the tissues and from there to the bones.
- Immunosuppressive Treatment-Related Kaposi Sarcoma – found in patients of a heart/liver/kidney transplant, who take drugs in order to prevent hurting the new organ by weakening the immune system. Once it is weakened, KS can develop.
- Epidemic Kaposi Sarcoma – found in HIV positive patients, where the immune system is weak by the virus. Symptoms, once again, are liaisons found in different parts of the body- skin, lining of the mouth, stomach and intestines, lungs and lining of the chest, liver or spleen. Usually the virus will spread to other parts of the body and a life threat is possible in later stages of the illness. Patients HIV positive with KS may suffer from fever, weight loss, and diarrhea. In recent years there is a drug-based treatment developed, called HAART, which reduces the risk of epidemic KS in HIV positive patients. This matter will be discussed later when different treatments for KS will be examined.
- Non-Epidemic Kaposi Sarcoma – the most odd type of KS; it is found in homosexual patients, who are not HIV positive; lesions are found every few years on the arms, legs, genitals and everywhere on the skin.
The different tests made in order to diagnose KS are: physical exam, chest x-ray, biopsy (a taken sample of cells in order to test for cancer trails), endoscopy (where organs of the body and tissues are looked at for abnormal areas), and bronchoscopy (looks inside a trachea and large airwaves in the lungs).
According to Dr. G. Quade of the National Cancer Institute (2011), the basic treatments used in the Western world, depending on the type of Kaposi Sarcoma, are:
- Radiation therapy;
- Combination of the listed above;
- Discontinue immunosuppressive therapy.
The choice of a treatment depends on the type of KS (which helps predict how fast the disease may grow and spread), the number of lesions, the kinds of problems the KS is causing, and the patient’s general health, according to the American Cancer Society. Moreover, in chemotherapy, patients that have other illnesses may not be able to cope with it. Thus, this may be excluded as an option for them, due to the side effects of the treatment.
In the last twenty years the new moderation of the treatment of KS is in HIV positive patients- it has been found that if the patient is treated with more anti-AIDS drug combinations, the immune system strengthens and reduces the chances of getting a KS. In cases in which the patient has already have KS, it improves the chances of survival and stop the tumour from spreading.
According to a study conducted by Ahmed A. And Mukhar H.M., KS patients that have HIV or their immune system is much damaged, must receive HAART treatments to strengthen the immune system, in combination with chemotherapy. Furthermore, palliative care should include pain relief in treatments that include radiation (p. 1-24)
The Cancer Treatment Centers of America says that unlike the Western traditions, Chinese traditions and the Eastern World, suggests other ways to support the KS treatments. Among these are the already collaborated treatments in many clinics throughout the United States: meditation, nutrition therapy, naturopathic medicine, acupuncture, image enhancement, and of course – mental support. All these are tools for pain management during the treatment of the disease. There is no indication whatsoever that these methods alone can show the same results if chemotherapy or radiation was not used at all. Traditional Chinese Medicine (TCM) has shown that it gives 70% result, unlike other traditional ways (30% efficiency).
To conclude, whether it is through a HAART treatment or an Eastern alternative medicine, Kaposi Sarcoma should be treated not only with chemotherapy and/or radiation, as it was done during the time in which I was diagnosed with it. The existence of these treatments have reduced the level of the weakened immune system and prolonged the lives of HIV positive patients, while fighting cancer as well. In addition, TCM will have fewer side effects on a patient due to its nature.
Fighting and overcoming Kaposi Sarcoma made me view the world from a different angle- living my life as if every day was my last day o Earth made me see the truly important things that mattered to me, what I wanted in life and a constant direction, without which today I would have been lost.
Although the treatments available today on the market give chance to many patients to live an almost normal life while having a KS treatment, the fact stays the same- every survivor learned the cost of living; HAART and alternative treatments reduced the range of mortality in patients with KS, reaching towards a new era, maybe less risky for HIV carriers.
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