AIDS-Related Malignancies

People who have AIDS are much more likely to get certain types of cancer than people without the disease. When people who have HIV develop certain cancers, healthcare providers consider their HIV infection to have progressed to AIDS. These types of cancer include Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer.

People with HIV or AIDS are also often more likely to develop cancer of the skin, anus, lung, and liver, as well as develop Hodgkin lymphoma.

Facts about AIDS-related malignancies

Kaposi sarcoma is a rare cancer among people who don’t have HIV. In fact, HIV infection increases the risk of Kaposi sarcoma by several thousand times compared with those who do not have HIV. People with HIV infection are at least 20 to 70 times more likely to develop non-Hodgkin lymphoma, 10 times more likely to develop Hodgkin lymphoma, and 25 times more likely to develop anal cancer. They are also 5 times more likely to develop cervical and liver cancer, and at least 3 times more likely to develop lung cancer than people who do not have HIV/AIDS.

Although AIDS is associated with an increased risk for several types of cancer, certain AIDS-related cancers have become less common. This may be because of the wider use of antiretroviral, or anti-HIV medicines, which combat the virus that causes AIDS.

When a person becomes infected with HIV, the immune system doesn't work as well. As a result, cancers may develop more quickly and become harder to treat, since the immune system usually helps fight cancerous cells before they turn into tumors. People who are taking anti-HIV medicines—medicines that help boost the immune system—may be better able to benefit from anticancer treatments.

Symptoms

Different types of AIDS-related cancers cause different symptoms. These may include:

• Kaposi sarcoma. A visible symptom of this cancer is purple or brown spots (lesions) on the skin or inside the mouth. The disease can affect internal organs and tissues. These include the lungs, digestive tract, and lymph nodes. It can also cause fever, diarrhea, and weight loss.

• Non-Hodgkin lymphoma. Symptoms are fever; unexplained weight loss; sweating at night; swollen lymph nodes in the underarms, groin, and neck; and a sense of fullness in the chest. Other symptoms can include memory loss, seizures, and fatigue.

• Cervical cancer. This may not cause symptoms, especially early in its growth. Eventually, however, cervical cancer may cause abnormal vaginal bleeding, discomfort during sex, and an unusual vaginal discharge.

• Anal cancer. Symptoms may include pain in the anal area, bleeding, itching, a change in bowel habits, or a lump in the area.

• Lung cancer. Symptoms can include severe coughing, which may bring up blood; chest pain; trouble breathing; fatigue; and weight loss.

Diagnosis

To diagnose Kaposi sarcoma, a healthcare provider may do a physical exam and remove a sample of a lesion to inspect under a microscope. You may also need a chest X-ray to see if the disease has affected your lungs. A healthcare provider may also need to inspect your lungs directly using a small scope to take pictures and tissue samples. Kaposi sarcoma can also affect the digestive system, so an endoscopy and/or colonoscopy may also be necessary to examine the upper and lower digestive tract.

Likewise, a number of tests may be needed to diagnose AIDS-related lymphoma, including blood tests and biopsies. Other tests might include CT or MRI scans. These create images of the inside of your body. The healthcare provider may also perform a physical exam to see how well your brain and nervous system are working. The healthcare provider may do a lumbar puncture to check the fluid in your spinal cord for cancer, as well.

A healthcare provider may find early cervical cancer, or cells that could become cancerous, during a Pap test. A healthcare provider may do a physical exam and a digital rectal exam to check for anal cancer. Other ways to diagnose this disease include inspecting the area with a special scope or removing cells to examine under the microscope.

To diagnose lung cancer, a healthcare provider may obtain images of your lungs with an X-ray, CT, or MRI scan. Blood tests may also be helpful. The healthcare provider may analyze mucus, fluid, or tissue from your lung. Other tests might be needed to look for cancer spread. 

Treatment

Healthcare providers may treat Kaposi sarcoma with anti-HIV medicines. Other treatments might include surgery (or other local treatments), chemotherapy, immunotherapy, and radiation.

Treatment for AIDS-related lymphoma may include the use of anti-HIV medicines, chemotherapy, and radiation. Treatment for cervical cancer often begins with a small procedure to remove the cancer. In some cases, chemotherapy, radiation, and/or surgery to remove the uterus and other tissues may be necessary as well. Surgery, chemotherapy, and radiation are also used to treat anal and lung cancers.

Prevention

Preventing infection from HIV will prevent AIDS-related malignancies. Important steps to lower your risk include:

• Not sharing needles or syringes with other people

• Avoiding unprotected sex

• Limiting how many sexual partners you have 

• Not coming into contact with other people's blood

• Getting tested for HIV and other sexually transmitted diseases on a regular basis

Other steps can help prevent some other types of AIDS-related cancers:

• Not smoking and avoiding secondhand smoke to lower your risk for lung cancer and some other cancers.

• Limiting your sex partners, using condoms, and not smoking to lower the risk for cervical cancer. Having regular checkups can allow your healthcare provider to find abnormal cells before they develop into cancer. Being vaccinated against the HPV virus might also reduce the risk in people who are not already infected.

Managing this condition

If you have an AIDS-related cancer, your healthcare provider may recommend steps you can take on your own to reduce your symptoms. Be sure to discuss the different therapies that are available for AIDS-related cancer with your healthcare provider since many treatment choices do exist.