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| Figure 1: Incidence Rate of AIDS related cancers |
a) Kaposi Sarcoma
Kaposi sarcoma is cancer where cells lining lymphs or blood vessels. It is marked by formation of black or purple colored lesions on skin or soft tissues. They usually appear on face and legs. These lesions are painful and swells. It is also possible to have such lesions/ tumors on soft tissues like mouth, lungs, digestive track or lymph nodes. There are different forms of Kaposi Sarcoma that are divided by American Association Of Cancer based on the region they are formed viz. Epidemic AIDS related Kaposi Sarcoma, Mediterranean Kaposi Sarcoma, Endemic Kaposi Sarcoma, and Transplant related Kaposi Sarcoma. However, the Kaposi Sarcoma cells remain similar.b) AIDS related Lymphoma
Lymphoma cancer is a type of problem cased due to uncontrolled growth of cells in lymph nodes. There are two types of lymphomas a) Hodgkin and b) Non-hodgkin lymphoma (NHL). People with Hodgkin lymphoma have abnormally large lymphocytes in lymph nodes. People with Hodgkin lymphoma can be cured easily. Whereas, Diagnosis method and treatment for NHL was discussed previously here.
c) Cervical cancer
It is a cancer of cervix in females. The cells in cervix do not choiange suddenly change to cancerous. They convert to precancerous such as i) cervical intraepithelial neoplasia (CIN), ii) squamous intraepithelal lesion (SIL) and iii) dysplasia. These precancerous conditions changes to squamous cell carcinoma (where exocervix joins endocervix) and adenocarcinoma (mucus producing cells of endocervix). Cervical adenocarcinoma is most common type of cancers.
Table 1: Diagnosis & Therapy of AIDS Related Cancer
| Cancer Type | Tissue Biopsy | Blood Tests | Biomarker and Gene mutation Tests | Urine Test | Imaging Tests | Other Tests |
|---|---|---|---|---|---|---|
| Kaposi Sarcoma | Punch biopsy for skin lesion | NA | NA | NA | X-Rays | NA |
| Excisional biopsy if entire lesion is removed | Bronchosopy | |||||
| Bronchosopy or endoscopy is done for biopsy of lungs and intestines | Upper endoscopy | |||||
| Colonoscopy | ||||||
| Capsulescopy | ||||||
| Double balloon enteroscopy | ||||||
| Hodgkin Lymphoma | Excisional or incisional biopsy of lymph node (microscopic identification of Reed-Sternber cells) | NA | CD15 and CD30 positive on surface of Reed-Sternberg cells | NA | NA | NA |
| Fine needle aspiration (FNA) or core needle biopsy | ||||||
| Bone marrow aspiration and biopsy | ||||||
| Non-Hodgkin Lymphoma (NHL) | Discussed Previously | |||||
| Cervical Cancer | Pap Test | NA | NA | NA | Cystoscopy, proctoscopy, and examination under anesthesia | NA |
| Colposcopic biopsy | MRI | |||||
| Endocervical curettage | CT Scan | |||||
| Cone biopsy | Chest X-ray | |||||
| Intravenous Urography |
Table 2: Chemotherapy for AIDS related cancers
| Cancer | Chemotherapy | Side Effects |
|---|---|---|
| Kaposi Sarcoma | Doxorubicin | Weaknening of heart muscles causing decrease in blood pumping capacity |
| Daunorubicin | ||
| Paclitaxel | Peripheral neuropathy, allergic reactions, low blood counts, low blood pressure | |
| Gemcitabine | flu like symptoms, fatigue, blood or protein in urine | |
| Vinorelbine | Muscle weakness | |
| Vinblastine | Fever,extreme fatigue, black or tarry stools, chest pain, presistant headache, urinary retention | |
| Vincristine | Abdominal cramps, peripheral neuropathy, severe abdominal pain, constipation | |
| Etoposide | Menopause, loss of fertility, peripheral neuropathy | |
| Hodgkin Lymphoma | Doxorubicin | DISCUSSED PREVIOUSLY |
| Vinblastine | DISCUSSED PREVIOUSLY | |
| Dacarbazine | Slight risk of leukemia, fever, low blood counts leading to increased the risk of anemia | |
| Etoposide | Menopause, loss of fertility, peripheral neuropathy | |
| Cyclophosphamide | Loss of fertility, discoloration of nails | |
| Procarbazine | low platelet and white blood cell counts | |
| Prednisone | Increased apetite, insomnia, heartburn, muscle weakness | |
| Mechlorethamine | Ringing sensation in ears, taste change, increased uric acid levels | |
| Vincristine | DISCUSSED PREVIOUSLY | |
| Non Hodgkin Lymphoma (NHL) | ||
| Cervical Cancer | Cisplatin | Peripheral neuropathy (nerve damage) |
| 5-fluorouracil | Cardiovascular problems | |
| Carboplatin | Peripheral neuropathy, central toxicity, hearing loss, infection | |
| Paclitaxel | DISCUSSED PREVIOUSLY | |
| Gemcitabine | DISCUSSED PREVIOUSLY | |
| Docetaxel | Pain and buring sensation in hand and feet, sensitivity to cold and heat | |
| Ifosfamide | Neurotoxicity and there is a risk of developing leukemia | |
| Mitomycin | Pulmonary fibrosis, pneumonitis, hemolytic uremic syndrome | |
| Irinotecan | Heart burn, dehydration, head ache, flatulence |
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