The treatment for Kaposi sarcoma (KS) is focused on symptom management and treating the cancer. The treatment will depend on the type of KS you have. Your doctor will consider several factors before making treatment decisions, including:
- Your overall health
- How well your immune system is working
- Whether you have symptoms
Treatment for KS can include drug therapy, surgery, topical medications, chemotherapy, radiation, or a combination of these.
There is no cure for KS, but with early detection and treatment, the five-year survival rate for the cancer is 81%.
Here is an overview of the treatment options for KS, including medications and surgery.
Types of Kaposi Sarcoma
There are four types of KS. The treatment for each type can be slightly different.
- Epidemic (AIDS-associated) Kaposi sarcoma: The most common type of KS in the United States, it develops in people who have HIV—the virus that causes AIDS.
- Classic Kaposi sarcoma: Classic Kaposi sarcoma is rare. It is more common in older men of Mediterranean, East Asian, or Jewish descent.
- Iatrogenic (transplant-related) Kaposi sarcoma: This type of KS develops in people who have had an organ transplant.
- Endemic Kaposi sarcoma: This is most common in sub-Saharan Africa where HHV-8 is more common. It usually develops in younger people (under the age of 40).
Treating Immune Deficiency
For AIDS-associated and transplant-related KS, it is important to treat any immune deficiency that exists.
For someone with AIDS, the most important part of KS treatment is anti-HIV drug combinations. In many patients, the KS lesions start to get smaller as their immune function gets better. In some patients with AIDS, antiretroviral therapy (ART) might be the only treatment needed to treat the KS.
As of February 2021, more than 40 drugs to treat HIV had been approved by the Food and Drug Administration, including 22 fixed-dose combination drugs that contain two or more antiretroviral agents. Your doctor will advise the best combination of ART for you.
In people who have had organ transplants, KS lesions sometimes go away on their own if the drugs that suppress the immune system are changed or stopped. A drug called sirolimus may be used in place of another anti-rejection drug because it can often make KS lesions get smaller.
Local treatments can be used on skin lesions that have already developed, but they cannot prevent new lesions from developing.
Topical creams do not stop the cancer, but they can improve the appearance of the lesions.
Alitretinoin, a retinoid drug related to vitamin A, is available as a gel that can be used to treat KS skin lesions. It can make the lesions smaller and might help them go away over several months.
The possible side effects of alitretinoin include skin irritation and lightening of the skin.
Imiquimod cream can also be used to treat KS skin lesions. It is applied three times a week for six months. Note, though, that it may cause some itching and redness around the areas where it is used.
If a person only has a few small KS lesions, they might be able to be removed with surgery. Surgical options for KS include:
- Cryosurgery: Cryosurgery can be useful for small KS lesions on the face, but it is not as helpful for large or deep lesions. With this surgery, liquid nitrogen is applied to the tumor to freeze and kill the cells.
- Simple excision: During an excision procedure, the skin is numbed with a local anesthetic. Then, the tumor and some surrounding healthy skin are cut out with a surgical knife.
- Electrodesiccation and curettage: During this surgery, the tumor is removed by scraping it with a long, thin instrument with a sharp looped edge on one end (curette). Then, the area is treated with an electric needle (electrode) to destroy any remaining cancer cells.
Even with surgery, it’s possible that a KS lesion might come back (recur) in the same place.
During photodynamic therapy (PDT), a special liquid drug is applied to the skin. The drug collects in the tumor cells over several hours or days and makes the cells sensitive to certain types of light. A special light source is then focused on the tumor(s), and the cells die.
A possible side effect of PDT is that it can make the skin very sensitive to sunlight, so precautions will be needed to avoid serious burns.
Radiation therapy is often used to treat KS skin lesions. The technique uses high-energy X-rays to destroy cancer cells while doing as little harm as possible to normal cells.
If KS is affecting organs inside the body, radiotherapy can be used to help address symptoms such as swelling, pain, and bleeding.
The possible side effects of radiation therapy can include skin changes, nausea, vomiting, anemia, and fatigue.
Systemic (Whole-Body) Therapies
Some treatments for KS are whole-body (systemic) treatments, which can be useful when cancer has spread throughout the body (metastasized).
If KS is more advanced, chemotherapy can be an option. The chemotherapy drugs that are used most often to treat KS belong to a group known as liposomal anthracyclines.
Liposomal chemotherapy uses very tiny fat spheres (liposomes) to carry anticancer drugs, such as doxorubicin. These spheres keep the drugs in the bloodstream longer, which means that more of the medicine reaches the cancer cells.
Patients with AIDS-associated KS should continue with antiretroviral therapy (ART) while they are undergoing systemic chemotherapy.
Two liposomal anthracyclines used in the United States to treat KS are:
- Liposomal doxorubicin (Doxil)
- Liposomal daunorubicin (DaunoXome)
Other chemotherapy drugs that can be used to treat KS include:
- Nab-paclitaxel (Abraxane)
- Gemcitabine (Gemzar)
- Vinorelbine (Navelbine)
The side effects of chemotherapy depend on the specific drug and the dose used, but they can include nausea and vomiting, hair loss, loss of appetite, diarrhea, fatigue, and low blood count.
Some people—especially those with advanced cancer—might decide not to have treatment. Even if you do not have treatment for KS, you can still talk to your doctor about managing your symptoms.
Immunotherapy boosts the body’s natural defenses to help it fight cancer. It uses materials that are made by the body or in a laboratory to improve, target, or restore immune system function.
Sometimes, KS responds to alpha-interferon (Intron A), which appears to work by changing proteins on the surface of the cancer cells and by slowing their growth.
Common side effects of immunotherapy for KS are decreased white blood cell count and flu-like symptoms.
Home Remedies and Lifestyle
People with KS need to keep their immune systems healthy and limit their risk of infection. If you are HIV-positive, that will mean taking your antiviral medicines regularly. You should also discuss vaccines and other infection-prevention measures with your doctor.
Over-the-counter (OTC) medications have not been proven to treat KS. While some manufacturers claim to make products that “boost” the immune system, they do not treat the infection or alter the course of the disease.
The overuse of OTC supplements can sometimes do more harm than good. For example, taking too much vitamin B6 or using supplements like garlic and St. John’s wort can affect the absorption of many HIV drugs.
Complementary and Alternative Medicine
There are no complementary or alternative therapies that can take the place of antiretroviral therapy in patients with HIV, or that are scientifically proven to improve the outcome of KS.
Talk to your doctor if you are considering trying any complementary therapy, as herbal remedies can interact with prescription medications.
Kaposi sarcoma (KS) is a type of cancer that often occurs in people with HIV, but can also occur in other people—especially if they have weak immune systems. There are several medical and surgical options for treating KS, and the appropriate treatment will depend on the individual. In some cases, especially if the cancer is advanced, treatment will be focused more on managing symptoms.
A Word From Get Meds Info
Kaposi sarcoma is incurable, but when it is found early and treated, the outlook is good. If you are diagnosed with KS, your doctor will decide on your treatment plan based on your overall health, how well your immune system is working, and whether you have symptoms that need to be managed.