Kaposi's Sarcoma: A rare cancer with viral links and challenges in its treatment.

Kaposi's sarcoma (KS) is a rare oncological disease that has recently garnered attention due to its particular nature and its relationship with other viruses. This type of cancer originates in the blood and lymphatic vessels, primarily manifesting on the skin through lesions that are often mistaken for bruises. However, unlike bruises, KS lesions are persistent and tend to increase in number and size, which can lead to alarming situations for patients. Dr. Ricardo Cubedo, a medical oncologist and head of the Medical Oncology Service at the MD Anderson Cancer Center Madrid, explains that although the most recognizable symptoms of KS are skin lesions, the disease can also affect internal organs such as the lungs and digestive system. This can manifest through symptoms like persistent cough, abdominal pain, intestinal bleeding, and, in some cases, chronic anemia or respiratory difficulties. This phase of the disease can be more challenging to detect and, therefore, more dangerous. One of the most surprising characteristics of Kaposi's sarcoma is its pattern of appearance. Unlike other types of cancer that develop in a specific location before spreading, KS can appear simultaneously in multiple parts of the body. This is due to its connection with blood vessels, which are present throughout the body, causing lesions to manifest in disparate places such as the legs, face, and internal organs like the liver or lungs. Kaposi's sarcoma is classified as a rare cancer, with an incidence in Spain of approximately one case per quarter of a million inhabitants. However, its prevalence is notably higher in equatorial African countries like Uganda and Tanzania, where the disease has reached epidemic levels in some populations. Dr. Cubedo emphasizes that in the 1980s and 1990s, KS was directly related to the AIDS epidemic in Western countries, although the situation has changed drastically today. The connection of Kaposi's sarcoma with human herpesvirus 8 (HHV-8) is a crucial aspect in understanding this disease. According to Dr. Cubedo, this virus is the primary trigger for the characteristic lesions of KS, especially in individuals with compromised immune systems, such as patients with AIDS or those who have received organ transplants. HHV-8 is transmitted through close contact and can remain latent in the body without causing disease until activated by factors such as immunosuppression. Dr. Cubedo also clarifies that KS is part of a group of viral cancers that includes other types such as cervical cancer and certain lymphomas. This relationship between cancer and virus highlights the importance of addressing public health not only through the treatment of diseases but also through prevention and education about the transmission of these viruses. Kaposi's sarcoma presents in several forms, including the classic type, which primarily affects older individuals of Mediterranean and Eastern European descent; the endemic type, common in sub-Saharan Africa; the epidemic type, related to HIV infection; and the iatrogenic type, which arises in immunocompromised patients after a transplant. Each of these variants has its specific characteristics and treatment methods, underscoring the need for individualized medical care. The diagnosis of KS generally begins with the observation of skin lesions, which are quite distinctive. However, to assess the extent of the disease, additional studies such as endoscopies and scans are required. This comprehensive approach is essential to determine the most appropriate treatment for each patient. Treatments for Kaposi's sarcoma depend on the severity of the disease and the patient's immune system status. In many cases, especially those related to HIV, antiretroviral treatment can reduce or even eliminate the lesions. For transplant patients, a possible solution could be adjusting immunosuppressive medication. In more advanced cases, specific chemotherapy treatments or local interventions, such as laser treatment for very localized lesions, may be considered. Kaposi's sarcoma is a clear reminder of the complexity of oncological diseases and their intricate relationship with viral and immunological factors. Ongoing research and education about this disease are essential to improve detection, diagnosis, and treatment, as well as to offer patients a more optimistic prognosis. Collaboration among healthcare professionals, patients, and the community can make a difference in the fight against this rare and often misunderstood form of cancer.