• Phillip shared his concerns regarding purple patches that were present on his skin and in his mouth
• He was diagnosed with Kaposi Sarcoma

Kaposi Sarcoma

• A disease in which cancer cells are commonly found in the skin or mucous membranes that line the gastrointestinal (GI) tract, from mouth to anus, including the stomach and intestines
• Appear as purple patches or nodule on the skin and/or mucous membranes, and can spread to lymph nodes and lungs
• Viral induced/associated – Herpesvirus 8, seen in HIV persons

Risk Factors for Men

• Weakened immune system in people who are HIV positive
• Organ transplant
• Weakened immune systems for other reasons
• Age > 60

Signs & Symptoms

1st  sign

• Lesions on skin

2nd sign

• Lesions on mucous membranes
• Lesions on inner linings of organs

3rd sign

• Shortness of breath
• Abdominal pain
• Anemia

Head-to-toe assessment

Skin

• Cosmetic

Feet

• Pain when walking (can use pain assessment)

Lungs

• Dyspnea
• Cough
• Hemoptysis

Gastrointestinal

• Weight loss
• Abdominal pain

Further Inspection

• Inspect face, around eyes, around ears
• Look at hard palate and gums
• Examine lymph nodes
• Look at dorsal and plantar aspect of feet
• Look for lymphedema of legs

Phillip’s Treatment

Phillip was distraught over his diagnosis and treatment.  He felt like it was a death sentence. He was adamant on getting better, and leaned on his partner for support. He is treated with a combination of drugs.

Treatment for Kaposi sarcoma is focused on managing symptoms and treating the cancer

Improving immune system function

The most effective and important therapy for patients with Kaposi sarcoma is addressing the immune deficiency that may allow the cancer to grow. For AIDS patients, the same antiretroviral therapy used for AIDS may be all that’s needed to treat Kaposi sarcoma.

Antiretroviral therapy

• Over 3-6 months, the lesions will improve in 80 percent of patients (paler, flatter)
• The skin will not look 100 percent the same as it once was

Chemotherapy

Patients who do not see improvement in Kaposi sarcoma after addressing immune deficiencies may require chemotherapy as a follow-up treatment. Chemotherapy is usually administered intravenously, although some oral therapies are now being used.

Levels of prevention

Primordial prevention

Prevent conditions that would enable the risk factors for disease from developing (e.g., public policy, education, campaign messages, awareness)

Primary prevention

• Impact of specific risk factor is lessened which leads to the reduction in occurrence or incidence of disease (interrupt chain of causality)
• Decreasing environmental risks
• Enhancing nutritional status
• Immunizing against communicable disease (e.g., condoms)

Secondary prevention

Aim to identify disease processes as early as possible (preclinical stage) which may reduce the prevalence of disease by curbing is duration (e.g., early screening)

Tertiary prevention

Aim at reducing the impact of long-term disease and disability by eliminating or reducing impairment or disability (focus on rehabilitation to minimize suffering and maximize years of functional life)

Quaternary prevention

Identify individuals or populations at risk of overmedicalization (guidelines and polices)