Those who have been diagnosed with HIV infections or AIDS can get cancer at any time and are at an increased risk of developing certain types of cancer. There are a group of cancers that are considered AIDS-defining conditions, which means their presence in a person that is infected with HIV shows a definite sign that full-blown AIDS has developed. Doctors are not sure exactly why certain cancers seem to arise in people with AIDS, however, they do feel it has much to do with the weakened immune system that the initial infection causes.
In countries like the United States, the treatments and care plan for cancer with HIV and AIDS has changed over the years as more treatment options and advancements have occurred. Certain AIDS-defining cancers have become less common as more people are getting more effective anti-HIV treatment, which helps to make the body stronger. The overall use of anti-HIV drugs has led to better cancer survival rates and better reception and body acceptance of full doses of chemotherapy and other standard treatments that would not be able to be taken without the anti-HIV medications. In the past, those with HIV or AIDS and cancer had a grim outlook on the last years of their lives.
What are the AIDS-defining cancers and how will they affect me?
The cancers that define and affect a person with HIV or AIDS are non-Hodgkin lymphoma, Kaposi sarcoma, and invasive cervical cancer.
Kaposi sarcoma is cancer that derives from the cells that line the walls of the lymph or blood vessels. At one time, this was a cancer that typically only affected older men of Eastern European or Middle Eastern ancestry, organ transplant patients, or young African men (ACS). In the past twenty years, there has been a steady increase of Kaposi sarcoma linked to men infected with the HIV or AIDS virus. This is referred to as epidemic Kaposi sarcoma. This is caused by a viral infection called the human herpesvirus 8, or HHV-8. In healthy people, this disease does not happen. This virus can be found in saliva and bodily fluids. In most cases, Kaposi sarcoma causes purple or brown spots or lesions to develop on the skin or in the mouth. This disease also affects the lymph nodes and other organs like the digestive tract, lungs, liver, and spleen. When this disease is first diagnosed it often shows no symptoms, especially if there are only a few lesions on the skin. Over time, epidemic Kaposi sarcoma does spread through the body and can be fatal.
Non-Hodgkin lymphoma is a cancer that begins in the lymphoid tissue and spreads into other organs. Due to the advancements in anti-HIV medications, the occurrence of this cancer is trending downward with a better control and treatment plan on care. Certain types of non-Hodgkin lymphoma are more common in people with AIDS. One of primary central nervous system lymphoma, which is a cancer that begins in the brain and spinal cord. Symptoms of this can include seizures, facial paralysis, memory loss, confusion, and extreme exhaustion. Fast-growing lymphomas, including diffuse large B-cell lymphoma and Burkitt lymphoma, are also more common in people with AIDS. The overall outcome for patients with these types of cancer depends on their immune system function and the type of lymphoma they have. Patients who are not taking anti-HIV medications will not have as good of an outcome as someone who has been regularly treated for HIV or AIDS.
Invasive cervical cancer is a cancer of the cervix or lower part of the uterus in women. Just as Kaposi sarcoma, invasive cervical cancer is linked to a virus. In this case, the virus is most often the human papillomavirus, or HPV, which can be spread from person to person through skin-to-skin contact, including sexual intercourse and activity. Women infected are at a higher risk for developing cervical intraepithelial neoplasia, which is the abnormal growth of pre-cancerous cells deeply in the cervix. This must be treated to keep this invasive cancer from spreading. This is done by removing and destroying the damaged cervical cells. If left untreated, in patients with HIV or AIDS, this condition is likely to become uncontrollable and can be fatal. The chance of reoccurrence from invasive cervical cancer is also very high, especially if full-blown AIDS is present.
Are there other types of cancers I should worry about being an HIV-infected patient?
There are other types of cancer that are more likely to develop in people with HIV and full-blown AIDS than in people without these conditions. These are:
- Squamous cell and basal cell skin cancer
- Testicular cancer
- Mouth and throat cancers
- Lung Cancer
- Liver Cancer
- Melanoma Skin Cancer
- Hodgkin diseases
- Anal Cancer
The link between HIV and cancer is still not fully understood by many in the medical industry. Certain cancers have been linked to infections of other viruses, and while these viruses can cause cancer in immune-healthy humans, they are more likely for those with HIV or AIDS. Liver cancer has shown to be more common in people infected with the hepatitis B or C virus. Some types of lymphoma have been linked to herpes and other viral infections as well. Mouth and throat cancers have been linked to the HPV virus, which is the same virus that causes cervical cancer.
In some cases, the higher risk for developing these cancers is solely because of the HIV infection itself. Mouth, throat, and lung cancers are strongly linked to smoking, which is more common in people with HIV, which increases the overall risk of developing these cancers. Cancers of the liver, throat, and mouth are also linked to heavy drinking and alcohol use and paired with the HIV-known infections affecting the mouth, this can create the perfect situation to give cancer cells room to grow.
As medical science and technology improves, those with HIV and AIDS are living longer, and beginning to develop the same cancers as people in the elderly years get. These more common cancers, like breast, colorectal and prostate cancer, can be treated as normal if the person has kept up with their medications and medical care during HIV flares and following the lifestyle needed to be as healthy as you can be. If you have AIDS and are concerned about your risk for developing certain cancers, talk with your doctor about the risks and course of treatment if something like this were to occur. Getting early treatment is key with any cancer, so do not wait to act.
Citations:
American Cancer Society
Mayo Clinic
National Institute of Health and Human Services