AIDS-Related Cancers

AIDS-related cancers are types of cancer that are more likely to occur in individuals with human immunodeficiency virus infection (HIV). Kaposi sarcoma, Non-Hodgkin’s lymphoma,  cervical cancer, Hodgkin’s lymphoma, and mouth, throat, liver, lung, and anus cancers are all correlated with AIDS.

Healthcare providers deem their HIV infection to have progressed to AIDS as individuals with HIV develop those cancers. These cancers are called cancers linked to AIDS or malignancies related to AIDS.

People who have AIDS are much more likely than people without the condition to get those kinds of cancer. That includes Kaposi sarcoma, non-Hodgkin lymphoma (NHL), and cancer of the cervix.

Some other cancers, called non-AIDS cancers, are often more likely to occur in people with HIV or AIDS (NADCs). In people living with HIV infection, these cancers are more likely to happen, but they are not an indication that the person has progressed to AIDS. Such cancers include:

• Head and neck cancer
• Anal cancer
• Lung cancer
• Liver cancer
• Hodgkin lymphoma

When a person becomes infected with HIV, the immune system doesn’t work as well as it should. As a result, the person is at higher risk for infections and long-term (chronic) diseases such as cancer.

Who is at risk for AIDS-related cancers?

Having HIV or AIDS increases the risk for cancers linked to AIDS. In fact, in individuals who do not have HIV, Kaposi sarcoma is rare.

AIDS is related to a higher risk of some cancer types. But cancers associated with AIDS have become less common. This is possibly because antiretroviral or anti-AIDS drugs are taken by people in the U.S.

The symptoms depend on the type of cancer:

• Kaposi sarcoma: This cancer causes purple or brown spots (lesions) on your skin or inside your mouth. It can also affect internal organs and tissues, such as your lungs, digestive tract, and lymph nodes. It can cause fever, swollen lymph nodes, and weight loss.
• Non-Hodgkin lymphoma: Common symptoms are fever, unexplained weight loss, sweating at night, swollen lymph nodes, and a sense of fullness in the chest. Lymphoma in the brain and spinal cord is common. The condition can cause memory loss, confusion, seizures, and extreme tiredness (fatigue).
• Cervical cancer: This cancer doesn’t cause symptoms until it’s grown and spread into nearby tissues. Then it may cause abnormal vaginal bleeding or discharge, pain during sex, and longer or heavier periods.
• Anal cancer: Symptoms may include pain in the anal area, bleeding, itching, a change in bowel habits, or a lump in the area.
• Lung cancer: Symptoms can include severe coughing, which may bring up blood. Other signs are chest pain, trouble breathing, fatigue, and weight loss.
• Head and neck cancers: There are many different kinds of cancer that start in these areas. Some common symptoms are mouth sores, headaches, and neck, throat, face, tooth, or ear pain. Abnormal bleeding in the mouth or from the nose may also occur.
• Liver cancer: This cancer can cause belly pain and swelling, yellowing of the skin and eyes (jaundice), weight loss, and tiredness.
• Hodgkin lymphoma: Symptoms are the same as for non-Hodgkin lymphoma.

Other health problems may look like the symptoms of AIDS-related cancers. To obtain a diagnosis, please ensure you consult a healthcare provider.

You will probably see the healthcare provider regularly if you have HIV. You will be asked about your health during these appointments and will have a physical examination. This helps the physician to track things like diseases and other issues, like cancer, for example.

You will need some tests if your physician feels you may have AIDS-related cancer. These are depending on the kind of cancer you might have. They can contain:

• Biopsy: Your healthcare provider may take a sample (small piece) of tissue from the lesion or lump. The sample is checked with a microscope to see if there are cancer cells in it.
• Blood tests: These can help diagnose some cancers and give an idea of your overall health.
• Imaging tests: X-rays and CT or MRI scans create images of the inside of your body. They may be used to look for and help diagnose different cancers.
• Other tests: Depending on your symptoms, you may need other tests. To check for cervical cancer, for instance, a woman’s doctor might perform a Pap test.  A lumbar puncture (spinal tap) may be done to look for lymphoma cells in the fluid that surrounds and cushions the brain and spinal cord.

Part of diagnosing cancer is called staging. Staging is the process of seeing if the cancer has spread and where it has spread. Staging also helps to decide on the best treatment options. There are different staging systems used for different cancers, but most range from stage 1 to stage 4, where a stage 4 is cancer that has spread to parts of the body. Talk with your healthcare provider about the stage of your cancer and what it means.

Treatment relies on what form of cancer associated with AIDS you have and how far it has spread across the body. You may need one of these treatments or more:

• Anti-HIV medicines: These can assist with HIV virus containment. They can help reduce the side effects of other treatments (such as infection) and improve your chance of recovery.
• Surgery: Removing the tumor may be an option for some cancers.
• Chemotherapy: These medicines can kill cancer cells or stop them from growing.
• Immunotherapy: This treatment helps the immune system focus on and kill cancer cells while causing little harm to healthy cells.
• Radiation: High-energy X-rays or other types of radiation can help shrink or kill cancer cells.

It is also an essential part of therapy to treat HIV infection itself. To control the virus, you will be given antiretroviral treatment (ART).

You can help reduce your risk of AIDS-related cancers by doing these things:

• Take your antiretroviral therapy correctly to keep your immune system strong.
• Don’t smoke, and stay away from secondhand smoke. Regular exercise can lower your risk for lung cancer and some other cancers, too.
• Limit your sex partners, use condoms, and don’t smoke. These actions can lower the risk of cervical cancer.
• Please check your hepatitis status. Liver cancer is linked to cancer in people with HIV infection. Some types of hepatitis can be treated.
• Know that the virus linked to Kaposi sarcoma is spread through saliva. Try to limit deep kissing and other contact with your partner’s saliva.
• Talk with your healthcare provider about the HPV vaccine. HPV infection is linked to some of these cancers. The HPV vaccine might help reduce the risk for people who are not already infected.

Get tested for cancer in these ways:

• Daily pelvic exams and Pap tests should be provided to women. This type of testing helps to detect and treat irregular cells in your healthcare provider before they turn into cancer.
• Please consider discussing anal Pap examination screening with your provider. This type of examination is a test for anus cells. It is done for women as well as for men. Although the study is still uncertain and not all doctors agree, this could help to find differences in anal cells so that before they become cancer, they can be treated.

You will need follow-up care during and after treatment to:

• Check on your response to the treatment
• Manage the side effects of treatment
• Look for the return or spread of cancer
• Keep the HIV under control