Kaposi Sarcoma: Chemotherapy
What is chemotherapy?
Chemotherapy (chemo) is the use of medicines that kill cancer cells. The medicines attack and kill cells that grow quickly, like cancer cells. But some normal cells also grow quickly. Because of this, chemo can also harm those cells. This can cause side effects.
How is chemotherapy given for Kaposi sarcoma?
Before treatment starts, you will meet with a medical oncologist. This is a doctor who specializes in treating cancer with medicines like chemotherapy. The doctor will discuss your treatment options with you and explain what you might expect.
Depending on which chemotherapy medicines you're getting and the reasons you're getting them, chemo can be given in different ways:
IV (intravenous). The chemo is given through a small catheter that's been put into a vein. The medicine may drip in slowly over several hours, or it may be given more quickly over a few minutes. When given this way, the chemo enters the blood and can reach cancer cells all over the body.
Intralesional. A small needle is used to inject the chemo medicine right into the KS lesions. The advantage of giving chemo this way is that most of it stays in the area where it was injected. This limits the side effects it causes. But chemo given this way can only treat the lesions it's injected into. It can’t reach cancer cells in other parts of the body.
Chemotherapy is usually given in an outpatient setting. That means that you get it at a hospital, clinic, or healthcare provider's office. You can go home after the treatment. Less often, you may need to stay in the hospital during treatment. Nurses will give the chemo and watch you closely for problems or reactions during treatments. Each chemo treatment may last for a while. You may want to take along something to do, like read a book, listen to music, or watch videos.
To reduce the damage to healthy cells and give them a chance to recover, chemo is often given in cycles. Each cycle consists of 1 or more days of treatment, followed by some time to rest and recover. Your healthcare provider will discuss your chemotherapy schedule with you.
When might chemotherapy be used for Kaposi sarcoma?
Chemotherapy can be used to treat KS in different situations.
Intralesional chemotherapy might be used to treat KS lesions that have affected how you look, or that are causing symptoms like swelling or pain. Intralesional chemo can often shrink these lesions. But it doesn't stop new lesions from forming in other parts of your body.
IV chemo is often used as part of the treatment for more advanced KS, or KS that is progressing quickly. For AIDS-related KS, chemo is given along with antiretroviral therapy (medicines to treat the HIV infection).
What chemo medicines are used to treat Kaposi sarcoma?
If IV chemo is needed to treat KS, medicines called liposomal anthracyclines are usually the first ones used. These are chemo medicines inside tiny fat bubbles called liposomes. The fat bubbles help the medicine get into the cancer cells and help cause fewer side effects. The liposomal anthracycline used to treat KS is called liposomal doxorubicin.
These medicines often produce good and long-lasting responses in many people by shrinking tumors and reducing swelling.
Other chemo medicines used to treat KS include:
Vinblastine is the most common medicine used for intralesional chemotherapy.
What are common side effects of chemotherapy?
Side effects of chemo are different for everyone. They depend on which medicines are used. Most can be treated and nearly all go away after treatment is over. Most of these side effects are much more common for IV chemo than for intralesional chemo. Ask your healthcare provider what side effects to watch for. Tell them about any side effects right away. It's important to treat them before they get worse.
These are some of the most common side effects from chemo:
Hair loss. Hair grows back after treatment stops.
Nausea and vomiting. This side effect can be controlled with medicines.
Mouth sores. Chemo can sometimes cause mouth sores. This might make it hard for you to eat or swallow.
Diarrhea. Talk to your healthcare provider about antidiarrheal medicines.
Loss of appetite or changes in the way things taste. Talk to your healthcare provider if you have trouble eating or are losing weight. There are often ways to help.
Increased risk of infection. During chemo treatments, your white blood cell count may become low. This means your immune system won’t work as well as it should. It’s a good idea for you to avoid people who have illnesses during this time. It’s also a good idea to take extra precautions against cuts and scrapes that could become infected. Your blood counts will be regularly checked during treatment. Be sure to let your healthcare provider know about any signs infection, such as fever, sore throat, a new cough, or burning during urination.
Bleeding and bruising more easily. Chemo can also lower your blood platelet counts. Platelets are needed to help the blood clot properly.
Fatigue. It's common to feel tired while getting chemo. This goes away over time once treatment ends.
Some other side effects can also be seen with certain chemo medicines. For example, vincristine, paclitaxel, and some other medicines can cause nerve damage (neuropathy). This can lead to pain, tingling, and numbness in your hands and feet.
Working with your healthcare provider
It's important to know which medicines you're taking. Write your medicines down. Ask your healthcare team how they work and what side effects they might have.
Talk with your healthcare providers about what signs to look for and when to call them. For example, chemo can make you more likely to get infections. Make sure you know what number to call with problems or questions. Is there a different number for evenings and weekends?
It may be helpful to keep a diary of your side effects. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage side effects.