Chemotherapy for Kaposi's sarcoma
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. There are different ways in which chemotherapy can be given to treat Kaposi's saracoma (KS).
We hope this section answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having your treatment.
Chemotherapy injected into the skin
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For small KS lesions that only affect the skin, chemotherapy is injected directly into the skin lesions. This is known as intralesional chemotherapy. It may be used instead of radiotherapy or areas or skin types where radiotherapy might cause darkening of the skin, particularly on the face. Intralesional chemotherapy can also be used for tumours inside the mouth.
The chemotherapy drug vinblastine (Velbe ®) is often used and it works best on smaller lesions. Intralesional chemotherapy can shrink skin lesions and make them lighter in colour. In some people, lesions may almost disappear completely.
Chemotherapy injected into a vein
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When KS is widespread on the skin or affects organs inside the body, chemotherapy is usually given into a vein. This is known as intravenous chemotherapy. The chemotherapy drugs travel in the bloodstream and reach KS in different parts of the body. This is sometimes called systemic treatment.
Chemotherapy into the vein is given as a session of treatment (cycle), usually over a few hours. This is followed by a rest period of a few days. This allows your body to recover from any side effects before you have your next cycle of chemotherapy. Your specialist will be able to tell you how many cycles you will need.
This is usually the first treatment used. The molecules of the chemotherapy drugs are enclosed (encapsulated) in a fat-based coating called a liposome. The liposomes travel to the tumour through the blood stream, where they release the chemotherapy drug. Liopsomal chemotherapy has fewer side effects than standard systemic chemotherapy. This means treatment can be given over a longer period.
The liposomal chemotherapy drugs that are commonly used to treat KS are:
These drugs are usually given as drips into a vein (intravenous infusions) every 2-3 weeks.
Other chemotherapy drugs which may be used to treat KS are:
Side effects of chemotherapy for Kaposi’s sarcoma
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Chemotherapy can cause side effects but these can often be well controlled with medicines. The side effects usually gradually disappear once your treatment is over. Some of the common side effects are listed below.
Risk of infection
Chemotherapy can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. Your white blood cells start to reduce seven days after treatment and are usually at their lowest 10-14 days after. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
you develop a high temperature, which may be over 37.5˚C (99.5˚F) or over 38˚C (100.4˚F) depending on the hospital’s policy - follow the advice that you have been given by your chemotherapy team you suddenly feel unwell, even with a normal temperature
you have symptoms of an infection - this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
The number of white blood cells usually increases steadily and returns to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cells are still low, your doctor may delay your treatment for a short time.
Bruising or bleeding
Chemotherapy can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets (platelet transfusion).
Anaemia (low number of red blood cells)
Chemotherapy can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells (blood transfusion).
Feeling sick (nausea)
This may happen in the first few days after chemotherapy. Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It’s easier to prevent sickness than to treat it after it has started.
If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug to one that works better for you.
Soreness and redness of the palms of the hands and soles of the feet
This may happen if you’re being treated with Caelyx. It’s called palmar-plantar or hand-foot syndrome. It gets better when treatment ends. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It can help to keep your hands and feet cool and to avoid tight-fitting socks, shoes and gloves.
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth and/or dentures morning and night, and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It’s important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
Some chemotherapy drugs can make your hair thin or fall out. You can ask your doctor whether the drugs you're taking are likely to cause hair loss. If your hair falls out, it will start to grow back again when your treatment finishes.
Chemotherapy given directly into the skin lesion (intralesional chemotherapy) may cause redness and swelling in that area. The skin may break down a little before it begins to heal.
Chemotherapy into a vein (intravenous) can also cause swelling, redness or pain if it leaks out of the vein. This is known as extravasation. Tell your nurse or doctor straight away if this happens.
You may feel tired and generally weak. Allow yourself plenty of time to rest and try not to overdo things.
Although all of these side effects may be difficult to cope with at the time they will usually disappear once your treatment is over.