1. Classic vs. Epidemic
Kaposi sarcoma (KS) used to be a rare form of cancer found mainly in men of Mediterranean or Jewish descent. This changed with the rise in HIV incidence. Now, doctors distinguish the rarer, classic KS from the epidemic KS that affects AIDS patients. AIDS patients who develop KS are dealing with a virus besides HIV. The human herpes virus 8 is a sexually transmitted virus that makes AIDS patients vulnerable to KS. In the early stages, KS causes purple lesions on the skin and mucous membranes. Doctors may inject anti-cancer drugs into these lesions. Advanced KS often affects the lungs and gastrointestinal tract. These patients may receive systemic chemotherapy as treatment.
2. Non-Hodgkin's Lymphoma
Non-Hodgkin's lymphoma (NHL) is an umbrella term covering all cancers that begin in the lymph system that don't feature the Reed-Sternburg cells unique to Hodgkin's lymphoma. Non-Hodgkin's lymphomas can grow slowly or quickly, but most AIDS patients develop aggressive types of NHL. The most effective therapy for aggressive types of NHL is chemotherapy, but some AIDS patients can't tolerate this treatment due to the damaging effects of chemotherapy on an already taxed immune system. AIDS patients who receive highly active antiretroviral therapy (HAART) can tolerate chemotherapy better than those who don't receive HAART.
3. Central Nervous System Tumors
The lymphatic system sends lymphocytes throughout the body to maintain immune function, including to the brain and spinal cord. AIDS patients are at risk for developing non-Hodgkin's lymphoma in these cells while they move through the brain or spinal cord, which doctors term primary central nervous system lymphoma. Symptoms of primary CNS lymphoma include neurological problems, like headaches, confusion, dizziness or an abnormal gait. Treatment options include whole brain radiation therapy and steroids to reduce swelling.
4. Special Concern for Women
Cancer of the cervix is an AIDS-related cancer of special concern to women. Patients may develop precancerous changes of the cervix that are very likely to change into an invasive cancer without treatment. It's important for women with AIDS to get regular pap tests, so doctors can treat any abnormal cervical changes before they develop into cervical cancer. Women with a reduced number of the CD4 variant of T cells in their immune system (less than 500) usually need systemic treatment like chemotherapy to supplement the local treatments of radiation therapy and surgery.
5. Anal Cancer
Having an impaired immune system increases the risk for anal cancer, a rare cancer of the gastrointestinal system. Researchers have also linked anal intercourse, multiple sexual partners and the human papilloma virus to developing anal cancer, which increases its prevalence among some AIDS patients. Doctors treat anal cancer with a combination of surgery, radiation therapy and chemotherapy, depending of the immune function of the patient and the extent of the disease.
