Kaposi Sarcoma: Treatment Choices

There are different treatment choices for Kaposi sarcoma (KS). Which may work best for you? It depends on a number of things, such as:

• The location and size of your KS lesions, and what types of problems they are causing

• Whether you are infected with HIV (and if so, how well the infection has been controlled)

• Your age and overall health

• What treatment side effects you’d find acceptable

Learning about your treatment options

You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. It is important to take the time you need to make the best decision.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get another opinion before deciding on your treatment plan. In fact, some insurance companies may require a second opinion. In addition, you may want to involve your family and friends in this process.

Understanding the goals of treatment for Kaposi sarcoma

In many cases, the goal of treatment is to cure the cancer. If cure is not possible, treatment may be used to shrink the cancer or keep it under control for as long as possible. Treatment can also improve your quality of life by helping to control the symptoms of the disease. The goals of treatment can include 1 or more of these things:

• Keep your immune system healthy

• Remove or destroy the KS lesions that have been found

• Remove or destroy tumors in other parts of your body

• Stop or slow the growth or spread of cancer cells

• Prevent or delay the cancer's return

• Ease symptoms from the cancer, such as pain or pressure on organs

Types of treatment for Kaposi sarcoma

Several types of treatment can be used for KS. Different combinations of treatment may be used, depending on the factors listed above. Sometimes more than 1 type of treatment might be used. Here is an overview of each type of treatment:

• Antiretroviral treatment. If you are infected with HIV (the virus that causes AIDS), keeping the infection under control with antiretroviral medicines is very important, and can often even help treat the sarcoma.

• Surgery and other local treatments. Surgery might be an option to remove lesions in some types of KS, especially if there are only a few lesions that are easy to reach. Other local treatments can also be used to destroy KS lesions in some cases. Local therapies include freezing a lesion using very cold temperatures (cryosurgery) and photodynamic therapy (PDT). Other local treatment options include applying a retinoid medicine to the lesions or injecting them directly with a chemotherapy medicine.

• Radiation therapy. Radiation therapy uses high-energy X-rays or radioactive particles to kill cancer cells. It can be used to treat larger KS lesions on the skin or in the mouth.

• Chemotherapy. Chemotherapy (chemo) uses medicines to either kill the cancer cells or stop them from dividing. If the medicines are given into the bloodstream, they can reach cancer cells throughout the body. That way they can treat cancer in parts of the body that would be hard to treat with other types of therapy. This type of treatment is said to be systemic. Chemo medicines can also be given directly into KS lesions if the cancer has not spread. This treatment is said to be local.

• Immunotherapy. This type of therapy uses medicines to boost the body's immune system. It is not used often to treat KS, as it can have serious side effects. 

• Supportive care. Your healthcare provider may advise therapies that help ease your symptoms, but don’t treat the cancer. These can sometimes be used along with other treatments. Or your healthcare provider may suggest supportive care if he or she believes that available treatments are more likely to do you more harm than good.

Clinical trials for new treatments

Researchers are always looking for new ways to treat KS. These new methods are tested in clinical trials. Talk with your doctor to find out if there are any clinical trials you should consider.

Talking with your healthcare provider

At first, thinking about treatment options may seem overwhelming. Talk with your doctors, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your healthcare provider before making a decision.