The AIDS Beacon™

HIV-positive individuals face a greater risk of acquiring AIDS defining cancers and non-AIDS defining cancers, according an article published in Oncology Reports.

An AIDS defining cancer is one that increases the risk of developing AIDS, once already infected with HIV.

The most common AIDS defining cancers are Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and cervical cancer. Non-AIDS defining cancers, which are still more prevalent in those with HIV, include anal and lung cancer.

AIDS Defining Cancers

Kaposi’s Sarcoma

Kaposi’s sarcoma is a type of skin cancer that causes patches to form on the skin. This cancer most often forms soft and spongy, purple colored lesions on the skin. These lesions will often harden and may form ulcers. Typically the lesions are not confined to the skin, but eventually affect the lungs, liver, and mouth. Kaposi’s sarcoma is linked to infection with a strain of herpes virus.

A biopsy, or chest x-ray, is a diagnostic test that may determine if an individual has this type of skin cancer. In most cases, highly active antiretroviral therapy (HAART) can be used to reduce the size of the tumors. HAART medication is usually a combination of three or more antiretroviral medications.

Surgical treatment or chemotherapy may also be used. However, for this form of cancer, chemotherapy is not a cure, but helps to prolong life.

In addition to being used to shrink tumors, adherence to HAART has also been shown to decrease the likelihood of developing Kaposi’s sarcoma.

Non-Hodgkin’s Lymphoma

Non-Hodgkin’s lymphoma, a second AIDS defining cancer, affects the lymph system, which is a part of the immune system that helps fight infections. It is 40 to 400 times more likely to develop in those with HIV. Symptoms of this cancer include sweating, fever, and swelling of lymph nodes in the back of the neck, underarm, or groin.

The study said that high-grade lymphoma is more prevalent in those with HIV. This study also said that previous studies have linked the use of HAART to a decreased prevalence of the cancer, while other studies have found no links.

According to a study published in the National Library of Medicine, high doses of chemotherapy and a CD4 cell count (white blood cell count) of 100 cells per cubic millimeter of blood or greater results in the best prognosis.

Chemotherapy is the treatment of choice for non-Hodgkin’s lymphoma. With advancement in antiretroviral therapy, most individuals with HIV can handle the same chemotherapy dosage that someone without HIV would receive.

Cervical Cancer

Cervical cancer, a third AIDS-defining cancer, affects the narrow part of a woman’s uterus. This type of cancer occurs in up to 29 percent of women with HIV. It is five to nine times more likely to develop in women with HIV than women who are not infected. Cervical cancer is linked to an infection with human papillomavirus (HPV).

Symptoms may include abnormal bleeding, painful urination, and pelvic pain. However, symptoms are usually not present until this cancer is more advanced.

Often times, a surgical option is used to treat cervical cancer. With more advanced forms, chemotherapy or radiation may be used.

It appears that those with HIV may be more likely to develop AIDS defining cancers for several reasons. HIV weakens the immune system and makes it easier for other viruses to remain active in the body. According to the New York State Department of Health, viruses work together to allow cancer cells to grow.

Non-AIDS Defining Cancers

Two of the most common non-AIDS defining cancers are lung and anal cancer.

Anal Cancer

Anal cancer is increasingly prevalent in the HIV community. Those with HIV are 30 to 50 times more likely to be diagnosed with this form of cancer, according to the study in Oncology Reports. In bi-sexual and homosexual men who are HIV-positive, this number increases to 60 times more likely.

Symptoms may include anal bleeding or pain near the anus. Anal cancer is also linked to an infection with HPV.

With most AIDS defining cancers and non-AIDS defining cancers, chemotherapy or radiation is the treatment of choice. However, this decision depends on many factors, such as the stage of cancer.

Lung Cancer

Lung cancer is another common non-AIDS defining cancer. A study published in the Journal of Clinical Oncology said that 33 out of 5,238 HIV-positive participants had lung cancer. Although 85 percent of those diagnosed with cancer were smokers, researchers still report that those with HIV have an elevated risk for developing lung cancer, independent of smoking.

However, the New York State Department of Health attributes the increased risk of lung cancer in individuals with HIV to an increased risk of smoking. It reports that 60 to 70 percent of those with HIV smoke.

Early stages of lung cancer may not produce any symptoms. Once symptoms occur, they may include chest pain, loss of appetite, coughing up blood, and shortness of breath.

There are different types of lung cancer that may occur, which effects the treatment used. However, surgery and either chemotherapy or radiation will be used in most cases.

Reducing The Risk Of Cancer

Early detection of cancer is the most important factor for a favorable prognosis. Individuals should always be vigilant for symptoms that indicate a cause for concern.

The New York State Department of Health said strict adherence to HAART medication may not reduce the risk of developing cancer (except with Kaposi’s sarcoma). However, it will strengthen the immune system. A strong immune system may be the best defense against certain types of cancers.

A healthy diet and exercise regimen will also help to strengthen the immune system. Foods that are high in antioxidants, such as blueberries and blackberries, may reduce the risk of some cancer. In addition to a healthy diet, the avoidance of excessive alcohol may reduce the risk of cancer.

Quitting smoking can reduce the risk of developing lung and other types of cancers as well as improve overall health.

Avoiding viruses such as herpes and HPV can also decrease the probability of developing cancer. Safe sex and avoiding shared needles are recommended.

For more information on HIV infection and cancer, visit the study in Oncology Reports or the New York State Department of Health. Please also see related AIDS Beacon articles about CD4 Counts And Cancer as well as Common Cancers Among HIV Patients.