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Different treatment options for Kaposi sarcoma were discussed
in the previous section, "How
is Kaposi sarcoma treated." Deciding which treatment to use
depends on a number of factors, such as
- the type of KS (which helps predict how fast the disease
may grow and spread)
- the number of lesions
- what kinds of problems the KS is causing
- the patient's health
These factors need to be considered because certain
treatments, such as chemotherapy, can have serious side effects.
Someone who is weak or sick from other problems may not be able to
tolerate chemotherapy. In a case like this, the chemo may do more harm
than good.
AIDS-related Kaposi sarcoma
For someone with AIDS, the most important part of KS treatment
is to fight the HIV infection with modern anti-AIDS drug combinations.
For many patients, KS lesions begin to get smaller as their immune
function gets better. In some patients with AIDS, highly active
antiretroviral therapy (HAART) may be the only treatment needed to
treat the KS. HAART also helps AIDS patients live longer and feel
better. Still, other treatments for KS may be needed to improve
symptoms (like pain and swelling).
A local treatment may be used for a few skin or mouth lesions.
KS tumors of the skin, mouth, or anus are sometimes treated with
low-doses of radiation therapy. As a rule, doctors use radiation
therapy to relieve symptoms or treat highly visible lesions. Sometimes
radiation is given to patients who can't get chemotherapy because they
are too weak or have poor liver function.
Chemotherapy may be added to HAART for patients with:
- many skin or mouth lesions
- severe swelling from KS (lymphedema)
- lung lesions causing shortness of breath
- lesions in the stomach and intestines that have caused
anemia (low red blood cells), weight loss, or other problems .
For chemotherapy, either one of the liposomal anthracyclines
or paclitaxel are usually chosen, If those drugs do not work, there are
other chemotherapy drugs that can be tried (see "Chemotherapy" in the
section "How
is Kaposi sarcoma treated?").
Classic Kaposi sarcoma
Classic KS grows and spreads slowly, so lesions are more often
treated with surgery or one of the local treatments. Chemotherapy may
be used for widespread skin lesions or advanced KS. KS is considered
advanced if it has spread to the lymph nodes or affects the lungs or
gastrointestinal tract. Liposomal anthracyclines or paclitaxel are the
drugs most often used for chemotherapy. Radiation therapy is also an
option for individual lesions or groups of lesions.
Transplant-related Kaposi sarcoma
Sometimes lesions disappear on their own if the drugs that
suppress the immune system are changed or stopped. A drug called
sirolimus may be used in place of another anti-rejection drug because
it can make Kaposi lesions get smaller. Skin lesions may be treated
with radiation therapy or a local treatment. Most doctors try to avoid
giving people who have had organ transplants chemotherapy for KS. But
some patients may agree to participate in clinical trials of new drugs.
Endemic Kaposi sarcoma
Because endemic KS occurs in poor countries, treatment options
are often limited. When available, the same treatments that are given
for classic KS may be used.
Kaposi sarcoma in HIV-negative men having
sex with men
This form of the disease is similar to classic KS, only
occurring in younger men. It is treated like classic KS.
Last Medical Review: 09/17/2009
Last Revised: 09/17/2009
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