Treatment

The treatment for Kaposi's sarcoma varies, depending on these factors:

• Type of disease. Historically, AIDS-related Kaposi's sarcoma has been more serious than classic or transplant-related disease. Thanks to increasingly effective antiviral drug combinations and improved prevention of other AIDS-related infections, Kaposi's sarcoma has become less common and less severe in people with AIDS.
• Number and location of lesions. Widespread skin lesions and internal lesions require different treatment from isolated lesions.
• Effects of the lesions. Lesions in the mouth and throat make eating difficult, while lesions in the lung can cause shortness of breath. Large lesions, particularly on the upper legs, can lead to painful swelling and difficulty moving around.
• General health. The immune system impairment that makes you vulnerable to Kaposi's sarcoma also makes certain treatments, such as powerful chemotherapy drugs, too risky to try. The same is true if you also have another type of cancer, poorly controlled diabetes or any serious, chronic disease.

For AIDS-related Kaposi's sarcoma, the first step in treatment is to start or switch to an antiviral drug combination that will reduce the amount of the virus that causes HIV/AIDS and increase the number of certain immune cells in your body. Sometimes, this is the only treatment needed.

When possible, people with transplant-related Kaposi's sarcoma may be able to stop taking immune system-suppressing medication. This allows the immune system to eliminate the cancer in some cases. Switching to a different immunosuppressive medication can also bring improvement.

Treatments for small skin lesions include:

• Minor surgery (excision)
• Burning (electrodessication) or freezing (cryotherapy)
• Low-dose radiation, which is also helpful for lesions in the mouth
• Injection of the chemotherapy drug vinblastine directly into lesions
• Application of a vitamin A-like drug (retinoid)

Lesions treated in any of these ways are likely to return within a couple of years. When this happens, treatment can often be repeated.

Radiation is the usual treatment for those with multiple skin lesions. The type of radiation used and the locations of lesions being treated vary from person to person. When more than 25 lesions are present, chemotherapy with standard anti-cancer drugs may be helpful. Chemotherapy is also used to treat Kaposi's sarcoma in the lymph nodes and digestive tract.