- How is Kaposi sarcoma treated?
- Treating immune deficiency and related infections in people with Kaposi sarcoma
- Local therapy for Kaposi sarcoma
- Radiation therapy for Kaposi sarcoma
- Chemotherapy for Kaposi sarcoma
- Biologic therapy (immunotherapy) for Kaposi sarcoma
- General considerations in the treatment of Kaposi sarcoma
Local therapy for Kaposi sarcoma
Local treatment only affects certain Kaposi sarcoma (KS) lesions (or areas of lesions). This type of treatment is often used to treat a few skin lesions in one spot to help a person look or feel better. Local therapy is most useful when there are just a few lesions in a very visible area (such as the face). The drawbacks of local therapy are that it doesn’t treat lesions anywhere else and it can’t keep new lesions from developing.
Topical retinoid treatment
This type of treatment puts medicine directly on the lesion. For example, alitretinoin, a retinoid drug related to vitamin A, is available as a gel (Panretin®) that can be used to treat KS skin lesions. When it is placed on a KS lesion 2 to 4 times a day, it makes it get smaller or go away in 1 to 2 months. Side effects of this gel include skin irritation and lightening of the skin.
Cryosurgery can be useful for small KS lesions on the face, although it is not as helpful for large or deeper lesions. Liquid nitrogen is applied to the tumor to freeze and kill the cells. After the dead area of skin thaws, it may swell, blister and crust over. The wound may take several weeks to heal, and the skin of the treated area may be lighter after treatment.
When a person has only a few, small Kaposi sarcoma lesions, one option may be to remove them with surgery. This can be done in different ways.
Simple excision: For this procedure, the skin is first numbed with a local anesthetic. The tumor is then cut out with a surgical knife, along with some surrounding normal skin. The remaining skin is carefully stitched back together, leaving a small scar.
Curettage and electrodesiccation: This treatment removes a tumor by scraping it with a curette (a long, thin instrument with a sharp looped edge on one end), then treating the area with an electric needle (electrode) to try to destroy any remaining cancer cells. This process can be repeated.
A drawback of surgery is that the lesion might recur (come back) in the same place.
For this treatment, a small amount of a chemotherapy drug is injected directly into the KS lesions. Very little of the drug is absorbed into the body. This lets the patient avoid many of the side effects normally seen with chemotherapy.
The most common drug used for intralesional chemotherapy in KS is vinblastine. Sodium tetradecyl sulfate (STS or Sotradecol®) can also be used. Some people may have swelling, blistering, and pain at the injection site with this type of treatment.
Photodynamic therapy (PDT)
This treatment uses a special liquid drug that is applied to the skin. The drug collects in the tumor cells over several hours or days and makes the cells sensitive to certain types of light. A special light source is then focused on the tumor(s), and the cells die. A possible side effect of PDT is that it can make the skin very sensitive to sunlight for some time, so precautions may be needed to avoid severe burns.
For more information on this technique, see Photodynamic Therapy.
Radiation can also be used as a local treatment for KS. This is discussed in detail in the next section.
Last Medical Review: 08/08/2014
Last Revised: 02/09/2016