Kaposi sarcoma: The enigma of cancer

Kaposi’s sarcoma is a type of cancer that affects the lining of blood and lymph vessels. Kaposi’s sarcoma tumours usually show as painless purplish patches on the legs, foot, or face. Lesions in the vaginal area, mouth and lymph nodes are also possible. Lesions in the gastrointestinal tract and lungs may occur in severe Kaposi’s sarcoma. People with weakened immune systems are more prone to it. Kaposi’s sarcoma rose to prominence during the early stages of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome epidemic. Since then, advances in medical research and treatment have dramatically reduced the number of people diagnosed with Kaposi sarcoma.

Is Kaposi’s sarcoma a rare disease?

Kaposi sarcoma is a very uncommon cancer. Kaposi sarcoma is most common in those who have AIDS/HIV in the United States. It is currently found in roughly six people per million who have AIDS/HIV. Kaposi sarcoma can also develop in persons who have had an organ or bone marrow transplant and are on immunosuppressive medication. Kaposi sarcoma affects about one out of every 200 transplant recipients. Patients of any age, including babies, can acquire this disease. There is a male preference in general. The absence of sex hormone receptors on Kaposi sarcoma tumour cells refutes a direct impact of sex hormones and indicates that other undiscovered processes may be at work in this sex bias.

Kaposi sarcoma comes in a variety of forms

Classic Kaposi Sarcoma

Classic Kaposi Sarcoma is more common among older Mediterranean, Eastern European, and Middle Eastern individuals. Men are more prone to have classic Kaposi Sarcoma. One or more lesions on the legs, ankles, or soles of the feet are the most common. Lesions in this type of KS do not grow as quickly as those in other types of KS, and new lesions do not appear as frequently. 

Epidemic Kaposi Sarcoma

Epidemic or AIDS-associated Kaposi Sarcoma is the most common kind of Kaposi Sarcoma in the United States. This kind of sarcoma appears in patients who have been infected with HIV, the AIDS-causing virus. A patient infected with HIV does not always get AIDS, but the virus can remain in the body for a long time, frequently years, before producing serious illness. 

Endemic Kaposi Sarcoma    

In some parts of Equatorial Africa, a large proportion of the population could be infected with Kaposi sarcoma–associated herpesvirus (KSHV), putting them at risk for Kaposi sarcoma. Medical specialists believe that the virus is primarily transmitted from mother to kid by saliva transfer. Women and children are among those who are affected. It’s unclear why the tumour develops in young boys but not in older men with classic Kaposi Sarcoma.

Transplant-Related Kaposi Sarcoma

Transplant-related Kaposi Sarcoma, occurs when a person’s immune system has been reduced as a result of an organ transplant. To prevent their immune systems from rejecting the new organ, most transplant recipients must take medications. These medicines, on the other hand, impair the immune system, making it more likely for someone infected with KSHV (Kaposi sarcoma-associated herpesvirus) to develop Kaposi Sarcoma. 

Diagnosis of Kaposi’s Sarcoma

For diagnosing Kaposi sarcoma, healthcare providers employ a variety of tests, but not all of them will be used with every patient. Some of them are biopsy, fecal occult blood test, chest x-ray, bronchoscopy, upper endoscopy and colonoscopy. Healthcare providers will strive to make all exams as comfortable as possible, regardless of the test used. Bronchoscopy is not required to diagnose Kaposi’s sarcoma until you have inexplicable respiratory issues or a chest X-ray that is abnormal. Similarly, you may be able to forgo upper endoscopy or colonoscopy unless a faecal occult blood test reveals blood in your stool.

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Prognosis and Therapy

Symptom relief, preventing Kaposi sarcoma progression, improving cosmesis, and reducing related edoema, organ impairment, and psychologic stress are all goals of Kaposi sarcoma treatment. Currently, there is no remedy for this disease. Surgical excision is only performed on Kaposi sarcoma lesions that are visually bothersome, to relieve discomfort, or to control local tumour progression. External beam radiation, laser therapy, cryotherapy, photodynamic therapy, topical alitretinoin gel, and intralesional vinblastine are some of the additional local therapies used to address bulky lesions or for cosmesis.

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Kaposi sarcoma’s rate of mortality and morbidity

Patients with classic Kaposi sarcoma (KS) are more likely to die from Kaposi sarcoma than from it. KS-AIDS patients typically die from opportunistic infections or gastrointestinal Kaposi sarcoma involving bleeding. Patients with KS-AIDS have a 15-24 month average survival rate, while the introduction of apparent immune system reconstitution using highly active antiretroviral therapy (HAART) in the United States has significantly increased survival. Gut perforation, cardiac tamponade, major lung obstruction, and, in rare cases, brain metastases can all be deadly complications of Kaposi sarcoma. A study was conducted that evaluated 204 patients with histologically verified classic Kaposi’s sarcoma (KS) who were found in 11 Italian community cancer registries to determine survival rates and the risk of second main cancer.

• https://pubmed.ncbi.nlm.nih.gov/8956798/

Visit the link provided below to learn more about the number of people diagnosed with Kaposi sarcoma each year.

• https://www.cancer.net/cancer-types/sarcoma-kaposi/statistics