People who are infected with the human immunodeficiency virus (HIV/AIDS) have a higher risk for certain types of cancer – specifically Kaposi Sarcoma, non-Hodgkin lymphoma and cervical cancer – than those who aren’t infected. These cancers are also known as “AIDS-defining malignancies” because a diagnosis of any one of these cancers marks the point at which the HIV infection has progressed to AIDS.
1. Kaposi sarcoma
Kaposi sarcoma, which has sometimes been wrongly referred to as the “AIDS rash”, causes patches of abnormal tissue growth under the skin, in the lining of the mouth and throat, or other organs. The red or purple patches – made up of cancer and blood cells – can be painful.
Kaposi Sarcoma is caused by the human herpes virus 8 (HHV8), and, unlike other cancers, starts in several areas of the body at once. Originally found mainly in Italian men and men of Eastern European Jewish descent, the cancer has become far more prevalent as a result of the HIV epidemic.
“Before the HIV/AIDS epidemic, Kaposi Sarcoma usually developed slowly,” explains Professor Michael Herbst of the Cancer Association of South Africa (CANSA). “In HIV/AIDS patients, though, the disease moves quickly. Treatment depends on where the lesions are and how bad they are. However, treating Kaposi Sarcoma does not improve survival from HIV/AIDS itself.”
Symptoms: Skin lesions that may be accompanied by fever, weight loss, fatigue, vomiting and nausea, and swelling in the arms and legs.
Treatment: Chemotherapy is used for the treatment of AIDS-related Kaposi Sarcoma, but whether it is given depends on whether or not the patient is strong enough to cope with the side effects of the treatment. In some cases, the cancer treatment drug interferon is also given as a treatment.
2. Non-Hodgkins lymphoma
Lymphoma is a type of cancer that involves cells of the immune system called lymphocytes, which form part of the lymphatic system and make antibodies that fight off germs and stop infections.
There are about 30 types of non-Hodgkins lymphomas (NHL). HIV-positive individuals have a greater risk of developing NHL – specifically Burkitt Lymphoma and Large B-cell Lymphoma – than the general population.
"HIV-positive patients and those with full-blown AIDS are at higher risk for NHL,” confirms Professor Herbst. “Most AIDS-related NHLs are high-grade [fast-growing] lymphomas.”
Symptoms: Swollen lymph nodes in the neck, underarms, groin or other areas, nights sweats, fever and chills that come and go, itching, and weight loss. If the cancer affects lymph nodes in the chest, coughing or shortness of breath may occur. If it affects the brain, symptoms may include headaches, seizures, concentration problems or personality changes.
Treatment: Radiotherapy, chemotherapy, a drug called rituximab (used to treat B-cell NHL), high-dose chemo followed by a bone marrow transplant, and radioimmunotherapy. The type of treatment depends on the type of lymphoma, stage of the cancer and wellbeing of the patient.
3. Cervical cancer
Cervical cancer, which is usually a slow-growing cancer, forms in the tissues of the cervix. It is almost always caused by the Human Papillomavirus (HPV). It starts as a pre-cancerous condition called dysplasia, which is completely treatable and can be detected by a Pap smear. Cervical cancer can spread to the bladder, intestines, lungs and liver.
HIV-positive women are at higher risk of HPV infection and persistence, says Professor Herbst. "Research shows that they are infected with a broader range of HPV strains. Research has also found that those who are treated with [life-prolonging] highly active antiretroviral therapy have a longer lifespan and are at a significantly higher risk to develop cancer of the cervix."
Symptoms: One of the most common symptoms of cervical cancer is abnormal vaginal bleeding. In some cases there are no symptoms until the cancer has progressed to an advanced stage. Then symptoms may include pain during sex, pelvic pain, offensive vaginal discharge, abnormal bleeding, painful urination, weight loss and lower back pain.
Treatment: Cryosurgery, hysterectomy (removal of the uterus), brachytherapy (internal radiation therapy), chemotherapy and external radiation therapy. If the cancer is advanced, more extreme surgery – radical hysterectomy (uterus and surrounding tissue) and pelvic exenteration (all the organs of the pelvis) – may be used.
For more info
Visit the CANSA website or call CANSA's helpline on 0800 22 66 22.
How Clicks Clinics can help you
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