Timely detection of Kaposi's sarcoma: key to effective diagnosis and treatment.

Kaposi's sarcoma (KS) is a rare type of cancer that originates in blood and lymphatic vessels, primarily manifesting on the skin as dark reddish spots or nodules. Although these lesions may initially be mistaken for bruises, one of the characteristics of KS is that they do not disappear; instead, they tend to increase in both number and size. This information was provided by Dr. Ricardo Cubedo, a medical oncologist and head of Sarcomas and Hereditary Cancer at the Medical Oncology Service of the MD Anderson Cancer Center in Madrid. Dr. Cubedo emphasizes that, in addition to its cutaneous appearance, Kaposi's sarcoma has the potential to affect internal organs, such as the lungs or the digestive system. "The main symptoms are skin lesions, but when the cancer affects internal organs, it can cause cough, abdominal pain, intestinal bleeding, chronic anemia, or respiratory difficulties," the specialist points out. This highlights the importance of early detection and proper diagnosis of this disease. A peculiar aspect of KS is that, unlike other types of cancer that usually start in one location and then spread, this type can manifest in multiple areas of the body simultaneously. This is due to its origin in the blood vessels, which are found throughout the body. Thus, a patient could present lesions on the legs and face at the same time as in an internal organ. Kaposi's sarcoma is considered a rare cancer, with an incidence of approximately one case per quarter of a million inhabitants in Spain. However, Dr. Cubedo warns that its prevalence is much higher in countries in equatorial Africa, such as Uganda, Kenya, or Tanzania. In the 1980s and 1990s, KS reached epidemic levels in many Western countries, including those in Europe, as a result of the AIDS pandemic. Although the incidence has decreased among HIV-infected individuals in developed countries today, the impact of the HHV-8 virus, responsible for KS, remains significant. Kaposi's sarcoma is intrinsically related to human herpesvirus 8 (HHV-8), which triggers the formation of the characteristic lesions of this disease, especially in individuals with compromised immune systems, such as those with AIDS or transplant patients. Dr. Cubedo explains that HHV-8 is exclusive to humans and is generally transmitted through close contact and sexual relations. There are different types of Kaposi's sarcoma. The classic form appears in older individuals, particularly of Mediterranean or Eastern European descent, while the endemic form is more common in sub-Saharan Africa, where the prevalence of HHV-8 is higher. On the other hand, the epidemic form affects people with HIV, especially before the introduction of antiretroviral treatments, and the iatrogenic form occurs in patients taking immunosuppressants after a transplant. Patients with HIV have an increased risk of developing KS, particularly if they do not receive antiretroviral treatment. This is because HIV weakens the immune system, creating a favorable environment for the activation of HHV-8. However, with current antiretroviral treatments, the risk of developing Kaposi's sarcoma has significantly decreased. The diagnosis of Kaposi's sarcoma is generally based on the observation of skin lesions, which are usually quite distinctive. Confirmation is made through a biopsy, and evaluating the internal extent of the disease may require endoscopies and scans. Treatment, according to Dr. Cubedo, varies depending on the extent of the cancer and the health of the patient's immune system. In cases related to HIV, antiretroviral treatment may be sufficient to reduce or eliminate the lesions. For transplant patients, it may be necessary to adjust immunosuppressive treatments. In more complex situations, chemotherapy treatments are available, although some localized lesions can be managed with more specific therapies, such as laser treatment. Understanding Kaposi's sarcoma is essential for improving its diagnosis and treatment, and education about this disease can be key to preventing and detecting it early. It is crucial that both healthcare professionals and patients are informed about the risks and symptoms associated with this type of cancer, especially in vulnerable populations.