Friday, March 11, 2016

Cancer diagnosis and chemotherapy Part-2 (AIDS Related Cancers)

Part-1 of series focused on diagnosis method for 12 most common cancer types. In the present series we have discussed about the other forms of cancers.  For the easement of reading about the cancer diagnosis procedure we have divided the series in segments. In this part of this series we will be discussing about AIDS (Acquired Immune Deficiency Syndrome) related cancer. There are three cancers that commonly occurs due to AIDS such as a) Kaposi Sarcoma, b)AIDS related lymphoma and c) Cervical cancer. Figure 1 shows incidence rates of all three types of AIDS related cancers. It indicates that NHL
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 TypeTissue BiopsyBlood TestsBiomarker and Gene mutation TestsUrine TestImaging TestsOther Tests
Kaposi SarcomaPunch biopsy for skin lesionNANANAX-RaysNA
Excisional biopsy if entire lesion is removedBronchosopy
Bronchosopy or endoscopy is done for biopsy of lungs and intestinesUpper endoscopy
Double balloon enteroscopy
Hodgkin LymphomaExcisional or incisional biopsy of lymph node (microscopic identification of Reed-Sternber cells)NACD15 and CD30 positive on surface of Reed-Sternberg cellsNANANA
Fine needle aspiration (FNA) or core needle biopsy
Bone marrow aspiration and biopsy
Non-Hodgkin Lymphoma (NHL)Discussed Previously
Cervical CancerPap TestNANANACystoscopy, proctoscopy, and examination under anesthesiaNA
Colposcopic biopsyMRI
Endocervical curettageCT Scan
Cone biopsyChest X-ray
Intravenous Urography

Table 2: Chemotherapy for AIDS related cancers

CancerChemotherapySide Effects
Kaposi SarcomaDoxorubicinWeaknening of heart muscles causing decrease in blood pumping capacity
PaclitaxelPeripheral neuropathy, allergic reactions, low blood counts, low blood pressure
Gemcitabineflu like symptoms, fatigue, blood or protein in urine
VinorelbineMuscle weakness

VinblastineFever,extreme fatigue, black or tarry stools, chest pain, presistant headache, urinary retention
VincristineAbdominal cramps, peripheral neuropathy, severe abdominal pain, constipation
EtoposideMenopause, loss of fertility, peripheral neuropathy
Hodgkin LymphomaDoxorubicinDISCUSSED PREVIOUSLY
DacarbazineSlight risk of leukemia, fever, low blood counts leading to increased the risk of anemia
EtoposideMenopause, loss of fertility, peripheral neuropathy
CyclophosphamideLoss of fertility, discoloration of nails
Procarbazinelow platelet and white blood cell counts
PrednisoneIncreased apetite, insomnia, heartburn, muscle weakness
MechlorethamineRinging sensation in ears, taste change, increased uric acid levels
Non Hodgkin Lymphoma (NHL)
Cervical CancerCisplatinPeripheral neuropathy (nerve damage)
5-fluorouracilCardiovascular problems
CarboplatinPeripheral neuropathy, central toxicity, hearing loss, infection

DocetaxelPain and buring sensation in hand and feet, sensitivity to cold and heat
IfosfamideNeurotoxicity and there is a risk of developing leukemia
MitomycinPulmonary fibrosis, pneumonitis, hemolytic uremic syndrome
IrinotecanHeart burn, dehydration, head ache, flatulence

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