Kaposi Sarcoma - Causes, Risk Factors and Treatment

What Causes Kaposi Sarcoma and How Is It Treated?

Kaposi Sarcoma (KS) is a kind of disease where cancer cells are found in the skin or mucous membrane lining the gastrointestinal (GI) tract, starting from mouth to anus, and includes the stomach and intestine. This is caused by an infection known as human herpesvirus 8 (HHV-8), also referred to as Kaposi sarcoma-associated herpesvirus (KSHV).

What are the risk factors of Kaposi sarcoma?

Kaposi sarcoma, a rare cancer, affects the internal organs and skin. It is prevalent eight times more among men than women. Certain factors increase the risk of developing this disease, such as:

• Age: If you are aged between 40 and 70 years, there is a high risk of developing Kaposi sarcoma.
• Ethnicity: People residing in specific areas of Africa are at high risk of developing endemic Kaposi sarcoma. On the other hand, those living in the Mediterranean or of Jewish descent are at risk of developing classic KS.
• Unprotected Sex: Usually, HHV-8 and HIV spread through body fluids. Thus, the risk of getting infected is high if you have unprotected sex.
• Immune Deficiency: If doctors prescribe you an immunosuppressant medicine after the transplantation of an organ or you have AIDS or HIV, there is a high risk of developing KS
   

What are the symptoms of Kaposi sarcoma?

The symptoms of Kaposi sarcoma include the following:

• Lesions on the Skin: The first and foremost symptom of Kaposi sarcoma is the cancerous spots appearing on the skin. These spots are red, purple, or brown and appear flat or raised. They can appear in any particular area of your body or several areas. Most commonly, these lesions are in the legs, feet, and face.
• Lesions Inside the Body: When lesions start appearing inside the lungs, you might face issues with breathing or experience blood in a cough. Lesions also cause pain and bleeding inside the gastrointestinal tract, leading to anaemia.
• Lesions on Mucous Membranes: Lesions can arise in the mouth, anus, or somewhere in the gastrointestinal tract.
• Lymph Nodes: Lymph nodes, present in the groin, can cause swelling in the legs, which can be painful.
   

How Do You Diagnose Kaposi Sarcoma?

Kaposi sarcoma has a variable global prevalence. It is most common in Sub-Saharan Africa (Endemic KS). The incidence of HIV-associated KS in developed nations decreased significantly with effective antiretroviral therapy but it remains an important disease, especially in immunocompromised individuals. 

If you experience symptoms of Kaposi sarcoma, a doctor will prescribe a physical examination of your mouth, skin, and rectum. Alongside this, the doctor will also examine your lymph nodes.

Let’s explore ways of diagnosing Kaposi sarcoma effectively:

• Chest X-ray: Kaposi sarcoma rapidly spread to the lungs. Hence, doctors may prescribe the majority of patients a chest X-ray. Doctors recommend this test even if there is no involvement of the lungs.
• Biopsy of Skin: While conducting a skin biopsy, small tissue pieces are removed from the lesion(s). Further, a pathologist examines samples in the laboratory to confirm the presence of Kaposi sarcoma.
• Bronchoscopy: If doctors detect any abnormality in the chest X-ray, or if you notice blood while coughing or face breathing problems, your doctors might suggest a bronchoscopy to take a look at the trachea in detail.
• Endoscopy: If there is blood in the stool, or you are experiencing pain and anaemia, go for an upper endoscopy and/or colonoscopy test.
   

In the past, Kaposi sarcoma was quite common among patients. Also, they used to experience an advanced stage of this disease. Nowadays, approximately 20 per cent of patients only have tumours or lymph nodes. The fall in this advanced disease has greatly resulted from the success of antiretroviral therapies.

What is the treatment followed for Kaposi sarcoma?

There is no specific treatment for Kaposi sarcoma. Treatment for this disease solely focuses on the good management of its symptoms and treatment of cancer. The treatment approach depends on the type of KS, the extent (stage) of the disease, and the patient's underlying immune status. 

Here are some treatment options to follow for patients experiencing Kaposi sarcoma:

• Improvement of Immune System Functioning: Addressing the deficiency of an immune disorder is the primary therapy for patients experiencing Kaposi sarcoma. Kaposi sarcoma patients should strengthen their immune system to prevent the growth of cancer cells.
• Chemotherapy: Even after addressing the immune deficiency, if there is no improvement, doctors prescribe chemotherapy as a follow-up treatment.
• Local Therapies: Some doctors recommend local therapies such as injecting chemotherapy directly into lesions, excisions, cryosurgery, local radiation, and phototherapy when only a few small lesions are present.
   

Kaposi sarcoma is usually present among people with weak immune systems. It leads to skin lesions and, at times, also affects internal organs. Treating the disease at an early stage helps in proper diagnosis as well. However, if you experience any unusual changes in your skin or a weak immune system, consult your healthcare professional immediately.