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Kaposi's Sarcoma
KS is characterized by tumors or lesions on the skin which may at first appear to be bruises, but are not sore and do not turn white when pressed as actual bruises do. They do not itch or contain puss, and may vary in color from pink to red-violet to brown to blue. Growth and spread of the lesions may vary from person to person. Because other diseases and even some nutritive conditions and allergies can cause blotchy skin discolorations and growths, a biopsy is needed to confirm the presence of KS. Any skin discolorations or lesions should be reported to a physician immediately, as tumors can begin growing in the lymph nodes and other internal organs before tumors on the skin appear. When the AIDS epidemic first began in the early 1980s, KS was nearly always the first sign that one had contracted AIDS, hence the early name for the syndrome, "gay cancer." This led to speculation that HIV caused the condition in addition to AIDS. Because nitrite inhalants, or poppers, were also being considered as a factor in the contraction of AIDS, many believed that poppers may have been a factor in the contraction of KS as well. However, most medical authorities believe that KS is not caused by HIV or AIDS, but rather that the virus and the immune disorder are co-factors in the development of KS - that is, the damage done to the immune system allows the tumors to grow unabated and more rapidly. Cases of KS in fact have been diagnosed in gay men who are not HIV positive or have not contracted AIDS. A recently discovered sexually transmitted virus, HHV-8, a strain of herpes virus, is believed by many to be the cause of KS. Some have even gone so far as named the virus KSHV, or Kaposi's Sarcoma Herpes Virus. Other medical authorities still point to poppers as a possible cause, noting that high doses of or prolonged exposure to nitrites can suppress the immune system and have a mutagenic effect on cells. Because they can suppress the immune system and damage cells, nitrites may also act as a co-factor in the spread of the HHV-8 virus through the body and/or the growth of tumors. In its early stages, KS can be successfully treated with direct injections of vincristine, direct applications of liquid nitrogen, or bombardment with x-rays. More advanced cases, especially if tumors are present internally, require chemotherapy, using combinations of vincristine with other drugs. Alpha interferon may be used, but only if the patient's T-cell count is over 200. Side effects are typical of chemotherapy, and can include hair loss, fatigue, nausea, chills, decrease in bone marrow and white blood cell counts, and flu-like symptoms. Recently, DaunoXome was approved for treatment of early stages of KS, and Doxil for more advanced cases. Taxol has also been approved, and the anti-herpes drug Foscarnet and various topical creams for lesions are also being considered at this writing. At the beginning of the AIDS epidemic, and before the condition itself was properly understood, KS was often the first sign that one had contracted AIDS. But steps are now possible to reduce the chances of contracting either of these conditions. Sexually active persons should always practice safer sex and limit or better yet discontinue their use of poppers and other illicit substances. They should also be tested regularly for HIV, and consult their physician immediately if a positive result comes back, so they can be advised of the best means of staying healthy and avoiding or delaying the onset of AIDS and KS.
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