Kaposi sarcoma is a type of cancer in which abnormal cells grow under the skin and in the lining of tissues, causing dark purple spots or lesions. Classic Kaposi sarcoma used to be a rare disease that affected mostly middle-aged men of Mediterranean and Jewish descent. Another type strikes people with a weakened immune system. During the early days of the HIV/AIDS epidemic, Kaposi sarcoma became one of the first visible signs that someone had that disease.
Because of their appearance, the lesions of Kaposi sarcoma may take an emotional as well as a physical toll. The cancer can also cause significant disability and even death. Your doctors will recommend how to treat the cancer based on your overall health and immune function, and the size, number, and locations of the lesions. When patients have an immune system that is functioning well, surgery is often recommended as a treatment for surface lesions.
Surgery works best if the cancer is confined to one area or a few specific places. The goal of surgery is to remove the existing cancer cells and, sometimes, nearby cells.
Surgeons use several options to remove Kaposi sarcomas:
Electrodessication and curettage. The surgeon uses a small surgical instrument called a curette to take out the cancer, then delivers electrical pulses through a tiny needle to the edges of the wound to stop the bleeding and kill any remaining cancer cells.
Freezing (cryotherapy). This procedure uses a specialized tool to freeze Kaposi sarcoma cells and tissue, which are then removed.
Local excision. This technique involves cutting the Kaposi sarcoma lesions out of your skin along with a small amount of tissue surrounding the cancer.
Before you undergo any of these options, your doctor will give you specific instructions for the day of the surgery. In general, you should avoid alcohol at least 24 hours beforehand, and if you smoke, you may need to stop up to two weeks in advance. As part of the prep work, you'll be asked if you have any allergies to certain medications or to latex, and to list the names of all the drugs and supplements you're taking. You may need to stop some or all of them before the surgery. Be sure to leave jewelry and any other valuables at home on the day of your surgery.
Other types of treatment that might be recommended along with or as an alternative to surgery are:
HIV/AIDS therapies. If you have HIV, treatments that help your immune system can also fight Kaposi sarcoma.
Radiation. Radiation therapy can kill cancer cells in the layers of the skin without harming deeper tissues, so it may be recommended for the treatment of some lesions.
Chemotherapy. Some anticancer drugs are taken orally and fight cancer throughout the body while others can be injected directly into the Kaposi sarcoma lesions or applied as a cream or gel.
Biological agents. Some medications use your body's immune system to fight Kaposi's sarcoma.
Depending on your doctor's recommendations and your situation, you might want to think about joining a Kaposi sarcoma clinical trial for treatment. Ask your doctor if there are any for which you might be eligible.
The surgery may get rid of your cancer completely, but there is a chance it may recur. Over the long term, you will need to follow up with your doctors to make sure your cancer has not come back. Make sure you understand when to go back to the doctor, both immediately after surgery and in the months and years that follow. The American Cancer Society recommends that you avoid smoking.