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Kaposi's Sarcoma General Information What is Kaposi's sarcoma? Kaposi's sarcoma (KS) is a disease in which cancer (malignant) cells are found in the tissues under the skin or mucous membranes that line the mouth, nose, and anus. KS causes red or purple patches (lesions) on the skin and/or mucous membranes and spreads to other organs in the body, such as the lungs, liver, or intestinal tract. Until the early 1980's, Kaposi's sarcoma was a very rare disease that was found mainly in older men, patients who had organ transplants, or African men. With the Acquired Immunodeficiency Syndrome (AIDS) epidemic in the early 1980's, doctors began to notice more cases of Kaposi's sarcoma in Africa and in gay men with AIDS. Kaposi's sarcoma usually spreads more quickly in these patients. If there are signs of KS, a doctor will examine the skin and lymph nodes carefully (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells). The doctor also may order other tests to see if the patient has other diseases. The chance of recovery (prognosis) depends on what type of Kaposi's sarcoma the patient has, the patient's age and general health, and whether or not the patient has AIDS. Stage Information Stages of Kaposi's sarcoma: There is no accepted staging system for Kaposi's sarcoma. Patients are grouped depending on which type of Kaposi's sarcoma they have. There are three types of Kaposi's sarcoma: Classic Classic Kaposi's sarcoma usually occurs in older men of Jewish, Italian, or Mediterranean heritage. This type of Kaposi's sarcoma progresses slowly, sometimes over 10 to 15 years. As the disease gets worse, the lower legs may swell and the blood may not be able to flow properly. After some time, the disease may spread to other organs. Many patients with classic Kaposi's sarcoma may develop another type of cancer later on in their lives. Immunosuppressive treatment related Kaposi's sarcoma may occur in people who are taking drugs to make their immune systems weaker (immunosuppressants). The immune system helps the body fight off infection. People who have had an organ transplant (such as a liver or kidney transplant) have to take drugs to prevent their immune system from attacking the new organ. Epidemic Kaposi's sarcoma in patients who have Acquired Immunodeficiency Syndrome (AIDS) is called epidemic Kaposi's sarcoma. AIDS is caused by a virus called the Human Immunodeficiency Virus (HIV), which attacks and weakens the immune system. Infections and other diseases can then invade the body, and the immune system cannot fight against them. Kaposi's sarcoma in people with AIDS usually spreads more quickly than other kinds of Kaposi's sarcoma and often is found in many parts of the body. Recurrent Recurrent disease means that the KS has come back (recurred) after it has been treated. It may come back in the area where it first started or in another part of the body. Treatment Option Overview How Kaposi's sarcoma is treated: There are treatments for all patients with Kaposi's sarcoma. Four kinds of treatment are used: -surgery (taking out the cancer) -chemotherapy (using drugs to kill cancer cells) -radiation therapy (using high-dose x-rays to kill cancer cells) -biological therapy (using the body's immune system to fight cancer) Radiation therapy is a common treatment of Kaposi's sarcoma. Radiation therapy uses high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation for Kaposi's sarcoma comes from a machine outside the body (external beam radiation therapy). Surgery means taking out the cancer. A doctor may remove the cancer using one of the following: -Local excision cuts out the lesion and some of the tissue around it. -Electrodesiccation and curettage burns the lesion and removes it with a sharp instrument. -Cryotherapy freezes the tumor and kills it. Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the original site. Chemotherapy for Kaposi's sarcoma also may be injected into the lesion (intralesional chemotherapy). Biological therapy tries to get the body to fight the cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy. Treatment By Stage Treatment of Kaposi's sarcoma depends on the type of Kaposi's sarcoma the patient has, and the patient's age and general health. Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of Kaposi's sarcoma. Classic Kaposi's Sarcoma Treatment may be one of the following: 1. Radiation therapy. 2. Local excision. 3. Systemic or intralesional chemotherapy. 4. Chemotherapy plus radiation therapy. Immunosuppressive Treatment Related Kaposi's Sarcoma Depending on the patient's condition, the cancer may be controlled if immunosuppressive drugs are stopped. If the patient cannot stop taking these drugs or if this does not work, treatment may be one of the following: 1. Radiation therapy. 2. A clinical trial of chemotherapy. Epidemic Kaposi's Sarcoma Treatment may be one of the following: 1. Surgery (local excision, electrodesiccation and curettage, or cryotherapy) with or without radiation therapy. 2. Systemic chemotherapy. Clinical trials are testing new drugs and drug combinations. 3. Biological therapy. 4. A clinical trial evaluating new treatments. Recurrent Kaposi's Sarcoma Treatment of recurrent Kaposi's sarcoma depends on the type of Kaposi's sarcoma, and the patient's general health and response to earlier treatments. The patient may want to take part in a clinical trial. The information on this page was obtained from the National Cancer Institute. The National Cancer Institute provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals. The National Cancer Institute is in no way affiliated with the Mary Stolfa Cancer Foundation. The information on this web site is provided for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. The MSCF disclaims all obligations and liabilities for damages arising from the use or attempted use of the information, including but not limited to direct, indirect, special, and consequential damages, attorneys' and experts' fees and court costs. 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