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Kaposi's Sarcoma

WHAT YOU SHOULD KNOW:

Kaposi's Sarcoma (Inpatient Care) Care Guide

  • Kaposi sarcoma, also called KS, is a type of skin cancer. This cancer is most common in people who have the human immunodeficiency virus (HIV) or acquired immunodeficiency disease (AIDS). People who have had an organ transplant may also get KS. You can get KS without having had an organ transplant, HIV, or AIDS. A virus called human herpes virus-8 (HHV-8) may lead to KS when your immune system is weak. The immune system fights infection in the body. KS may appear on any part of your skin. It can also be found in your lymph nodes, stomach, intestines, liver, spleen, lungs, and bones. This disease may remain in one area on your skin and need very little treatment, or it may spread to other areas or organs. KS may spread quickly through your body or may stay unchanged for a long time.

  • KS may appear on your skin as blue, red, purple, or brown spots (lesions) anywhere on your body. The lesions and the area around them may be painful and swollen. The lesions may also be in your mouth, lymph nodes, stomach, intestines, liver, spleen, lungs, or bones. Caregivers will examine you and do tests to learn if you have KS and where it is in your body. Tests may include taking samples of blood or tissue (biopsy), x-rays, computed tomography (CT) scan, or ultrasound. Treatment depends on your signs and symptoms and on where the lesions are. Treatments may include medicine, radiation therapy, cryotherapy (freezing the lesions), or surgery. These treatments may kill cancer cells, strengthen your immune system, or fight HHV-8 and HIV. Treatment for KS may decrease the size and amount of lesions on or in your body. It may also decrease symptoms, such as pain and swelling.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Chemotherapy can weaken your immune system and make it harder for you to fight new infections. The number of red blood cells in your body may decrease, making you feel tired or weak. Chemotherapy can cause mouth sores, vomiting, or hair loss or can make you bruise easily. Some chemotherapy may cause nerve, heart, or lung problems. This therapy can also cause constipation (dry, hard stools that are difficult to pass). Chemotherapy may cause redness, itching, peeling, numbness, or tingling of your hands and feet. Chemotherapy medicine given as a cream, gel, or injection may cause pain.

  • Interferon may cause problems in your liver; weaken your immune system; or make you feel tired, weak, or very sad. Highly active antiretroviral therapy (HAART) medicine may cause other medicines to stop working as well. Radiation may cause mouth sores, redness, pain, or changes in the color of your skin. Cryotherapy may cause blisters or pain. Even with treatment, your lesions may get smaller for only a short period of time. Your lesions may not go away, or they may increase in size or number.

  • If you do not get treatment for KS, your lesions may spread. Symptoms, such as pain or swelling, may get worse. KS may spread to other organs in your body, such as your lungs, and you may die. Talk to your caregiver if you have questions or concerns about KS or its treatment.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Tests:

Your caregiver will look for lesions on your body, and you will have blood taken for tests. You may also need one or more of the following tests to help caregivers plan your treatment:

  • Biopsy: A biopsy is when caregivers take cells out of your body through a needle. The biopsy may be taken from a lesion on the skin, or a sample may be taken from a bone or lymph node. A lymph node may need to be removed. The biopsy sample is sent to a lab and tested for KS.

  • Chest x-ray: A chest x-ray is a picture taken of the lungs and heart. The x-ray may show lesions in your lungs or if you have an infection, such as pneumonia.

  • Computed tomography scan: This test is also called a CT scan. During this test, an x-ray machine uses a computer to take pictures of your chest or other body areas. You may be given dye through an intravenous (IV) tube that is placed in your vein. The dye helps body areas show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to dye. Tell your caregiver if you are allergic to shellfish or dye.

  • Endoscopy or bronchoscopy: An endoscopy is done so that caregivers can look inside your stomach and intestines. A bronchoscopy is done so that caregivers can look inside your airways and lungs. A scope (a long, bendable tube with a light on the end of it) is used for these tests. For an endoscopy, the scope is put in through the mouth and moved down your esophagus to your stomach and intestines (bowels). During a bronchoscopy, the scope is moved down your airways and into your lungs. During an endoscopy or bronchoscopy, samples of tissue may be collected from your airways, lungs, stomach, or intestines. These samples are sent to a lab for tests.

  • Magnetic resonance imaging: This test is also called an MRI. During this test, pictures are taken of your abdomen, bones, and other body areas. You will need to lie still during an MRI. Never enter the MRI room with any metal objects because this can cause serious injury. Tell your caregiver if you have any metal in or on your body.

  • Ultrasound: An ultrasound uses sound waves to take pictures of your organs and tissues. The pictures are seen on a TV-like screen.

Treatment options:

Your treatment depends on where the KS is located and on your signs and symptoms. You may need one or more of the following:

  • Medicine:

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

    • Chemotherapy: Chemotherapy works to stop cancer cells from growing and kills new cancer cells. Chemotherapy may be injected (given as a shot) into skin lesions. It may be given through an IV to treat KS in other body areas.

    • Topical chemotherapy: Chemotherapy is often called "chemo". The word topical means it is put on the skin as a lotion or cream. This medicine is used to treat cancer that is in the outer layers of the skin. Topical chemotherapy is put on to kill cancer cells. While being treated, your skin may hurt and look very red.

    • Interferon: Interferon is used to strengthen the immune system. It may also help stop HHV-8 from growing.

    • Highly active antiretroviral therapy: If you have HIV or AIDS and KS, your treatment may include highly active antiretroviral therapy (HAART). This therapy uses three or more medicines that work together to stop HIV from growing. If HIV stops growing, then HHV-8 may also stop growing. HAART is usually given with chemotherapy.

  • Treatments and surgery:

    • Support stockings: If you have swelling in your legs or feet, you may need to wear support stockings or compression garments. The stockings put pressure on your feet and legs and may decrease swelling and pain. Support stockings are often worn during the day and are removed at night. Ask caregivers how to take care of your skin while wearing support stockings. Raising your legs up on pillows while sitting or lying down may also decrease swelling.

    • Physical therapy: A special caregiver called a physical therapist can show you exercises to help you move more easily and with less pain. You may be fitted with special shoes or shoe inserts. Ask caregivers to help you plan an exercise program to follow at home.

    • Blood transfusion: You may need a blood transfusion if you have lesions that are bleeding inside your body. During a blood transfusion, you are given whole blood, or parts of blood, through an IV. You may be worried about getting AIDS, hepatitis, or West Nile virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile virus.

    • Cryotherapy: Cryotherapy treatments freeze and remove lesions on the skin. If you need cryotherapy, ask caregivers for more information about it.

    • Radiation therapy: During radiation therapy, x-rays or gamma rays are used on KS lesions to decrease their size. This therapy may also decrease pain in the area of your lesions.

    • Surgery: Your skin lesions may be removed with surgery. If KS is in your bones or other body areas or organs, you may need other kinds of surgery. Ask your caregiver for more information if you need surgery.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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