HIV/AIDS and Cancer

People with HIV/AIDS have a high risk of developing certain cancers, such as Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer (see below). For people with HIV, these three cancers are often called “AIDS-defining conditions,” meaning that if a person with an HIV infection has one of these cancers it can signify the development of AIDS.

The connection between HIV/AIDS and certain cancers is not completely understood, but the link likely depends on a weakened immune system. Most types of cancer begin when normal cells change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body). The types of cancer most common for people with HIV/AIDS are described in more detail below.

Epidemic (AIDS-related) Kaposi sarcoma

The most common type of KS in the United States is epidemic or AIDS-related KS. This type of KS develops in people who are infected with HIV, the virus that causes AIDS. A person infected with HIV (that is, who is HIV-positive) does not necessarily have AIDS. The virus can be present in the body for a long time, typically many years, before causing major illness. The disease known as AIDS begins when the virus has seriously damaged the immune system, which results in certain types of infections and other medical complications, including KS. When HIV damages the immune system, people who also are infected with a certain virus (the Kaposi sarcoma herpesvirus or KSHV) are more likely to develop KS. The risk of developing KS is closely linked to the CD4 count. The CD4 count is a measure of the effect of HIV on the immune system. The lower the CD4 count, the more likely that the patient will get KS.

KS is considered an "AIDS defining" illness. This means that when KS occurs in someone infected with HIV, that person officially has AIDS (and is not just HIV positive).

Treatment of HIV infection with highly active antiviral therapy (HAART) has resulted in fewer cases of epidemic KS. It can often keep advanced KS from developing. HAART doesn't completely protect against KS; it can still occur in people whose HIV is well controlled with HAART. Sometimes people on HAART get aggressive KS that requires treatment with chemotherapy, radiation, or some other therapy. Once KS develops it is still important to continue HAART. In areas of the world where HAART is not easy to obtain, KS in AIDS patients can advance quickly and cause death in just 6 months. 

Classic (Mediterranean) Kaposi sarcoma

Classic KS occurs in elderly people of Mediterranean, Eastern European, and Middle Eastern heritage. Classic KS is more common in men than in women. Patients typically have one or more lesions on the legs, ankles, or the soles of the feet. Compared to other types of KS, the lesions in this type do not grow as quickly, and new lesions do not develop as often. The people who get classic KS come from areas where KSHV infection is more common than in the United States or Northern Europe. The immune system of people with classic KS is not as weak as it is in those who have epidemic KS, but it may be weaker than normal. Getting older can naturally weaken the immune system a little. When this occurs, people who already have a KSHV infection are more likely to develop KS. 

Endemic (African) Kaposi sarcoma

Endemic KS occurs in people living in Equatorial Africa and is sometimes called African KS. KSHV infection is much more common in Africa than in other parts of the world, increasing the risk of KS there. There appear to be other factors in Africa that contribute to the development of KS since the disease affects a broader group of people that includes children and women.

Endemic KS tends to occur in younger people (usually under age 40). Rarely a more aggressive form of endemic KS is seen in children before puberty. This type usually affects the lymph nodes and other organs and can lead to death within a year.

Endemic KS used to be the most common type of KS in Africa. Then, as AIDS became more common in Africa, the epidemic type became the most common type seen in that area. 

Iatrogenic (transplant-associated) Kaposi sarcoma

When KS develops in people whose immune systems have been suppressed after an organ transplant, it is called iatrogenic, or transplant-associated KS. Most transplant patients need to take drugs to keep the immune system from rejecting (attacking and killing) the new organ. By weakening the body's immune system, these drugs increase the chance that someone infected with KSHV will develop KS. Stopping the immune suppressing drugs or lowering their dose often makes KS lesions disappear or get smaller.

Kaposi sarcoma in HIV negative men who have sex with men

Recently, there have been reports of KS developing in men who have sex with men who are not infected with HIV. In this group, the cases of KS are often mild, similar to cases of classic KS.

Common types of cancer

Other, less common types of cancer that may develop in people with HIV/AIDS are Hodgkin lumphoma, angiosarcoma (a type of cancer that begins in the lining of the blood vessels), anal cancer, liver cancer, mouth cancer, throat cancer, lung cancer, testicular cancer, colorectal cancer and types of skin cancer including basal cell cacinoma, squamous cell carcinoma, and melanoma

Last Medical Review: 10/26/2011
Last Revised: 01/24/2012                                                                                                               
http://www.cancer.net/cancer-types/hiv-and-aids-related-cancerobtained February 9, 2013

http://www.hivinfectionandaids/hiv-infection-and-aids-h-ow-are-h-i-vand-a-i-d-srelatedtocancer obtained February 9, 2013

National Black HIV/AIDS Awareness Day

February 7 is National Black HIV/AIDS Awareness Day, an opportunity to promote HIV prevention, testing, and treatment among African Americans in the United States.

Our site is dedicated to cancer and the diseases that affect our community. HIV/AIDS still has  higher rates among Afro Americans than whites. People with HIV/AIDS have a high risk of developing certain cancers. 

African Americans are disproportionately affected by HIV. The Centers for Disease Control and Prevention (CDC)  estimates that they accounted for nearly half (44%) of all new infections in 2010, despite making up only 14% of the population. This represents a rate that is eight times as high as that of whites.

Most of these infections are in African American men, most of whom are men who have sex with men (MSM). Young black MSM, in fact, account for more new infections than any other subgroup by race/ethnicity, age, and sex.

While African American women, also continue to be far more affected by HIV than women of other races/ethnicities, recent data show early signs of an encouraging decrease in new HIV infections. CDC is cautiously optimistic that this is the beginning of a longer-term trend.

 http://www.cdc.gov/features/blackhivaidsawareness/obtained February 9, 2013

Happy New Year 2013

Reducing Health Disparities in Cancer

We at Muriel Lights' will continue to make prevention our top goal; but listening to your body is most important and making sure you have a doctor who is listening to you is your goal.  Cancer death rates continue to decrease but early detection is still a problem amoung racial and ethnic groups here is some information provided by CDC.

• Improve early detection of cancer through routine mammography, Pap tests, and colorectal cancer screening.
• Implement evidence-based community interventions to increase screening and modify risk behaviors.
• Develop research projects that will encourage minority groups to participate in clinical trials for cancer prevention to ensure that significant differences between minority and ethnic groups are identified.
• Undertake research that will inform decisions about interventions to reduce cancer disparities and improve health. There is a growing need for interventions that are available to people regardless of socioeconomic status or lifestyle behaviors that also addresses the social environment.
• Use a variety of media and channels to market cancer information to diverse populations in a variety of settings.

Access to quality cancer care and clinical trials needs to be expanded to ensure that minority groups are provided the same care and access to state-of-the-art technology that patients in major care centers receive.
Fear of cancer, perceived cost of care, and lack of physician referral are common barriers to cancer screening and other preventive services. Health care providers play a critical role in recommending and increasing use of preventive services. Research shows that physician recommendation is a major predictor of receipt of screening.

Cancer Among Children
Among children aged 19 years or younger, cancer incidence rates increased 0.6% per year from 2004 through 2008, continuing trends from 1992. Death rates decreased 1.3% per year during the same period.

Cancer Among Racial and Ethnic Groups

Black men and white women had the highest cancer incidence rates between 2004 and 2008. Black men and black women had the highest cancer death rates during the same time period, but these groups showed the largest decreases for the period between 1999 and 2008, compared with other racial groups.
CDC and other public health agencies, health care providers, and communities of all racial and ethnic groups must become partners in a national effort to—

 http://www.cdc.gov/cancer/healthdisparities/basic_info/disparities.htm

A Caregivers Story

This is my last post for 2012 it has been a while since I have blogged on my site, again cancer walked into my life and my focus had to be on the real life walk as a caregiver who was helping a love one battle cancer.  My husband lost that battle on November 4, 2012.   I started this site because I found myself burying relative after relative from the disease of cancer and feeling like those cancers were always found at the end stage of their cancers.  My husband cancer was no different he went to the doctor well over a year before he was diagnosed with end stage gastric neoplasm in an emergency room.   They gave him colon and prostate testing determined to find cancers he did not have when a blood test would have given them the actual cancer he did have.  He was diagnosed on June 26, 2012 and died only a few months later.   He tried two different chemo treatments the first so toxic he had to be hospitalized the second he managed to tolerate well with no hair loss or side effects.  Given his prognosis I ask myself why did he do chemo and the answer is even when we are given the options we will do what it take to live.  As a caregiver my goal was to stand behind his decision and his right to fight for his life and I am not alone.

More than 65 million people, 29% of the U. S. population, provide care for a chronically ill, disabled or aged family member or find during any given year and spend an average of 20 hours per week providing care for their loved one. The value of the services family caregivers provide for “free,” when caring for older adults, is estimated $375 billion a year.  That is almost twice as much as is actually spent on homecare and nursing home service combined (158 billion).

And to us the value is priceless, in the end for me caring for him left me whole instead of my heart broken in a thousand pieces.  If ever there was a time for a person to have a love one there by your side cancer would be the disease.  Family member’s visits, helping with taking their love ones to appointment, advocating, visiting as much as possible making every day count is what is important.  Cancer is not a kind disease; chemo in its battle to save your life can take away as much as it gives.  Understanding medication, nutritional needs and the emotional toll on the patient (family member) also for you is still another challenge.   

To say this was easy would be an understatement because in those month’s our goal was to extend our love one’s life but at the same time we are given the opportunity to share last moments together that can never be forgotten.  I remember thinking to myself this is not a movie where everything is oh so perfect in spite of the knowledge I was going to lose my husband and best friend my thoughts was how am I going  to do this.    Anger is part of the course for both of us why him?  Why me?  How is our family going to take the news? Why did the doctors take so long to find the cancer?  Then you go about the job of living with cancer which consists of frequent clinic visits, chemo, blood drawings , medication, telling family, friends and tears.

There is no true moment when you may know when they have had enough or they have accepted that they no longer want to continue chemo or any of their treatments but they know.  My husband missed his chemo treatment because of Sandy but the last time he had chemo he was good he didn’t need a shot to boost his immune system.  But he told me even before he was not taking any more chemo he was tired but he was reschedule for a chemo appointment anyway.  He didn’t make it he went to the emergency room because he was not feeling well.  When I was getting him ready to go to the doctor it was like he legs give way I remember on the way to the hospital him telling me he was not coming back home.  I stayed with him overnight for the last three days he spent in the hospital going home to change clothes little by little the body shuts down and you have to make a decision about quality of life versus being hooked up to machines because they will keep doing what they want until you say stop. 

Most important job for the caregiver is to listen, relative usually tell us what they want whether we choose to listen or not. During my husband last stay in the hospital the doctors kept trying to get him to sign D&R or paper to make me responsible for making medical decisions if he could not, he never signs them but as his legal wife I still had the right to make those decisions.   My husband told me months ago if his heart stopped don’t bring him back or keep him hooked to machines.   He told me to go home that last day he knew I needed a little time out from the hospital, I told myself I was not going to stay that night but I was dressed waiting for my son to take me back to the hospital he had just left after visiting his father with his brothers and sister.

The phone rang that night and the doctor was on the phone they had went to my husband room and he was non-responsive they were working on him now but it did not look good. I called all of the family and raced to the hospital when we got there he was hooked to a respirator.  I thought he had died but he waited for me, the doctor stated he was out too long, cancer was too advanced no matter what he was not going to survive his cancer and most likely the blood clot he had on his liver had moved and caused a stroke leaving him brain dead.   My husband in the end left here surrounded by love we prayed, we cried, we touched his warm hand and spoke to him and most of all we let him go the way he wanted to leave this earth as only caregivers can do because we listen.and we love to the end. 

http://www.thefamilycaregiver.org/index.cfm

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP;obtained December 2012

Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving;
National Alliance for Caregiving and Evercare obtained December 2012

SHORTAGE OF LIFE SAVING CANCER DRUGS

There is a shortage of life saving cancer drugs that could save lives that are not available because those drugs are now less expensive and are there’s no profit motive for companies to produce these generic drugs that sell for very little cost.   These drugs are not being produced because they don’t produce a large profit to manufacturer who can profit better when that drug is at its greatest demand.  In the meantime children with cancer are now facing a Methotrexate shortage in a few short weeks. Methotrexate is the primary treatment drug for acute lymphoblastic leukemia. In November, one of the four U.S. manufacturers of Methotrexate was shut down because of quality concerns, this move emptied pharmacy shelves, the FDA say they have given the green light for companies that produce Methotrexate to ramp up production.  There are still 200 hundred shortages of life saving drugs the FDA needs to look at a long term solution so we never have this problem again.