Kaposi's Sarcoma

WHAT YOU SHOULD KNOW:

• Kaposi's (kuh-poe-zees) sarcoma (sar-ko-muh) is also called "KS." It is a skin cancer that people with AIDS (acquired immunodeficiency (ih-mew-no-duh-fish-in-c) syndrome (sin-drom) may get. Scientists think that KS is probably caused by a virus (germ). Most people who get KS have a weakened immune system. This system is the part of your body that fights infection.
  
  
• This cancer may first show up on the face, legs or mouth as purple spots or skin sores. You can also get KS in your lungs, liver, or other organs. Chemotherapy (kee-mo-thair-uh-p), radiation (ra-d-a-shun), or surgery may be used to treat KS. You may need to go into the hospital for tests and treatment.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

If the KS is not treated, it may spread and you could die. Your medicine or radiation treatment may cause unpleasant side effects. Even if you are treated, the KS may come back or spread. But your chances of stopping the KS are better if you are treated. Call your caregiver if you are worried or have questions about your medicine or care.

WHILE YOU ARE HERE:

Activity:

• You may need to rest in bed. You may be allowed out of bed once you are feeling better. If you are not allowed out of bed, you can still exercise your legs in bed. Do this by lifting one leg off the bed and drawing big circles with your toes. Then do it with the other leg. Another good exercise is to lay on your side and pretend to pedal a bike. This makes your legs stronger and stops blood clots from forming. Stop if you become tired.
  
  
• Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver.

Breathing: It may be easier for you to breathe if you rest with the head of your bed raised. You can also breathe easier if you rest your head on 3 or 4 pillows. Resting in a reclining chair may also help you breathe better. Another way to breathe easier is by saving your energy and resting more.

Call Button: You can use a call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call.

Informed Consent: You have the right to understand your health problem in words you can understand. You should be told what tests, treatments, or procedures may be done to treat your problem. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Diet: Eat healthy foods from all of the 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. Eating healthy foods may help you feel better and have more energy. It may also help you heal faster. If you have trouble swallowing, eat foods that are soft or in liquid form. If you cannot make yourself eat, let your caregiver know.

Fluid: Try to drink 6 to 8 (soda-pop can size) glasses of liquid each day. It is especially important to do this if you are vomiting from chemotherapy. Or follow your caregiver's advice if you are on a fluid limit. Good liquids to drink are water, juices, and milk. Limit the amount of caffeine you drink such as coffee, tea, and soda.

Gown: A hospital gown is needed so that your caregivers can easily check and treat you. Put your gown on so that it opens in the back. When you feel better you may be able to wear your own gown or pajamas.

Heart Monitor: This may also be called an EKG or an electrocardiogram (e-lek-tro-kar-d-o-gram). It is a painless test to see how your heart is working. Sticky pads (3 or 5) are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit). This screen or box shows a tracing of each heartbeat. Caregivers watch this tracing all the time to make sure your heart is doing well.

Intake/Output: Your caregivers may need to know the amount of liquid you are getting. They may also need to know how much you are urinating. Caregivers often call this "I&O."

• When you are allowed, drink 6 to 8 (soda-pop can size) glasses of water each day. Or, follow your caregiver's advice if you must limit the amount of liquid you drink. If you are on I&O, tell your caregiver how much liquid you drink.
  
  
• Ask your caregiver if it is OK to flush your urine down the toilet. It may need to be measured before it is thrown away.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube will be capped or connected to tubing and liquid.

Medicines:

• Anti-itching medicine: Caregivers may give you medicine to help keep your skin from itching. This medicine may be given in an IV, as a shot, by mouth, or as a skin lotion. Sometimes this medicine can make you sleepy.
  
  
• Antiviral(an-ti-vi-rull) Medicine: This medicine may be given to fight an infection caused by a germ called a virus. Antiviral medicine may be given by IV, as a shot, or by mouth.
  
  
• Pain Medicine: Caregivers may give you medicine to lessen your pain. This medicine may be given in your IV, as a shot, or by mouth. Tell caregivers if the pain does not go away or comes back.

Oxygen: You may need extra oxygen during your illness or injury. It may be given through a plastic mask over your mouth and nose. Or, it may be given through nasal prongs (short, thin tubes in your nose). Tell your caregiver if the oxygen is drying out your nose or if the nasal prongs bother you. Don't take off your oxygen without asking your caregiver. If you do, your body may not have enough oxygen.

Postural Drainage: It is also called "PD." This is a treatment to help loosen the sputum (spit) in your lungs. A caregiver will lightly clap on your back and chest with his hands. This will break up the sputum in your lungs making it easier to cough up. Or, your caregiver may use a machine to lightly clap on your chest and back. PD can make it easier to breathe and help you get better faster.

Pulse Oximeter (oks-ih-mih-ter): This is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.

Reverse Isolation (i-so-la-shun): You are given a private room to protect you from other people's germs. You may be in reverse isolation if your body is having a hard time fighting infections. Caregivers and visitors may wear gloves, facemask, or a gown to keep their germs away from you.

Tests: You may need one or more of the following tests to help your caregivers plan your treatment.

• Biopsy (bi-op-c): This is when a small piece of tissue is removed and sent to the lab for tests. Your skin is first cleaned. Caregivers will put numbing medicine into your skin so you will have little pain. A bandage will be put on the biopsy area after the tissue sample is taken.
  
  
• Blood Gases: These are tests that are also called "ABGs." Blood is taken from an artery in your wrist, elbow, or groin. It is tested for the amount of oxygen, acids, and carbon dioxide (di-oks-ide) in your blood. ABGs may be done if you have trouble breathing or other problems caused by your illness.
  
  
• Blood Tests: You may need blood taken for tests. The blood can be taken from a vein in your hand or from the bend in your elbow. It will be tested to see how your body is handling your illness. You may need to have blood drawn more than once.
  
  
• Bone Scan: This is a test to look at your bones. You will be given a small, safe amount of radioactive dye in an IV. Pictures will then be taken of your bones. Caregivers can look at the pictures for broken bones. These pictures can also show infections or cancer in the bones
  
  
• Bronchoscopy (bron-kah-skuh-p): This is a test that may be done to look inside your airways and lungs. It is also used to get tissue samples. Caregivers use a bronchoscope (bron-kuh-skop). It is a long tube with a light and magnifying glass on the end. The scope goes in your mouth and into your lungs. Your caregiver will give you medicines for pain or medicine to help you relax during the bronchoscopy.
  
  
• Chest X-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are handling your illness. Caregivers may use the x-ray to look for signs of infection, pneumonia (new-moan-yuh), or collapsed lungs. Chest x-rays may also show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• CT Scan: This is a test that may also be called a "CAT" scan. A special x-ray machine uses a computer to take pictures of organs in your body. Caregivers look at the pictures to learn more about your problem. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the body organs show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell caregivers if you are allergic to any of these.
  
  
• Endoscopy (end-oss-kuh-p): This is a test to look inside different organs in your body. Caregivers will put a scope in your mouth or anus (rear end) and into the organ that may be causing problems. The scope is a long tube with a magnifying glass and light on the end. The scope may be hooked to a camera and pictures may be taken of the organ causing problems. The scope may be used to take a tissue sample for tests. During this tests small tumors can be removed or bleeding can be stopped.

Treatment Options: Your treatment may change if the KS is not being controlled. This is often decided after you have tests. You may have some of the following treatments alone or together.

• Biologic (bi-o-lah-jik)Therapy: It is also called biotherapy or immunotherapy (im-u-no-thair-uh-p). It is given as a shot or in an IV. This medicine is used to help the body fight growing cancer cells. It also may make cancer cells weaker and easier to kill. You may feel like you have the flu during this therapy.
  
  
• Chemotherapy (kee-mo-thair-uh-p):
  
  
  • This is medicine used to treat cancer. Chemotherapy is often called "chemo." It works by killing new tumor cells. Chemo may also be used to shrink lymph nodes that have cancer in them. Many different chemo medicines are used to treat cancer. Chemo may be taken as a pill, as a shot, or in an IV.
    
    
  • You may need blood tests often. These blood tests show how your body is doing and how much chemo is needed. Chemo can have many side effects. You may be more likely to get infections or have other problems. Chemo can cure some cancers. Even if the chemo does not cure your cancer, it may help you feel better, or live longer.
  
  
• Curettage (kure-uh-taj) & Electrodesiccation (elek-tro-des-ih-kay-shun): This is a kind of surgery used to treat the skin cancer. You may need it more than once.
  
  
  • The skin in the area of the cancer is numbed with medicine. This is called a "local." Once the skin is numb, the tumor (bump) is scraped off with a sharp, spoon-shaped tool. This is called curettage.
    
    
  • Electricity is then used to heat a needle. This stops bleeding and kill any cancer cells left behind. The needle does not send electricity into your body. This is called electrodesiccation. A white scar may be seen once the treated skin heals.
  
  
• Radiation (ra-d-a-shun): Radiation is like x-rays. Radiation kills cancer and keeps the cancer from spreading. It also keeps cancer cells from dividing into new cells, which is one way cancer spreads. Lymph nodes with cancer will also be treated with radiation. In some cancers, radiation may be given after surgery to kill cancer cells that were not removed. It may also be given with chemotherapy. Radiation may help lessen pain, control bleeding, and shrink the tumor.
  
  
• Surgery: You may need surgery to take out the cancer. Caregivers may use one or more of the following to remove the cancer. A local excision (ek-sih-shun) may be done to cut out the spot, sore, or bump. Caregivers may also remove some of the tissue around it. Cryotherapy (kri-o-thair-uh-p) freezes the spot, sore, or bump and kills it.

Vital Signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine, which will give your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope (steth-uh-skop). Your vital signs may be taken so caregivers can see how you are doing.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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