Author: David Rowlands
Lowering cancer risk
The risk of developing many types of cancer is higher if the infection is not well controlled. If the CD4 count is low. This is one reason why it is important for people with HIV to stay on their medicines to help keep the infection under control.
The risk of some of types of cancer that are more common in people with HIV may be lowered by avoiding certain cancer risk factors. For example, not smoking or using injection drugs and limiting alcohol may help lower the risk of some cancers. Some types of cancer linked with HIV are caused by viruses that can be spread through sex, so using safer sex practices may also help protect against those cancers.
Vaccines against the hepatitis B virus may help protect against one possible cause of liver cancer. Vaccines are also available to help protect against certain human papilloma virus (HPV) infections, which may help prevent some cervical, anal, and other cancers. But the HPV vaccines are only effective if they are given before a person becomes infected with HPV, so they are typically recommended before a person becomes sexually active.
Finding cancer early
Screening is the process of looking for cancer in people who do not have any symptoms. While people with HIV are at a higher risk for certain cancers, for most of these cancers there are no screening tests proven to help lower the risk of dying from them. Regular medical check-ups are important to look for possible signs or symptoms of these cancers in people with HIV.
“Early detection tests that are recommended for people without HIV, such as screening tests for breast or colorectal cancer, can also help detect cancers in people with HIV”
How is cancer treated in people with HIV?
Before effective anti-HIV drugs became available, the outlook for people with HIV who developed cancer usually was not nearly as good as it was for people with similar cancers who were not infected. People with HIV were often already sick, or at least had a weakened immune system, before they even started cancer treatment. Today, people with HIV and cancer are usually treated much like people without HIV infection.
Some aspects of treatment may need to be adjusted in people with HIV. For example, cancer treatment may sometimes need to be changed because of other conditions in people with HIV. Some anti-HIV drugs can also interact with many other drugs in the body, which can complicate cancer treatment. Anti-HIV drugs can also have their own side effects, some of which can be the same as those caused by chemotherapy.
“Treatment of both HIV and cancer can be complex,
so it is very important that both treatments are coordinated by doctors who have experience with these diseases”
David Rowlands discusses the risks of certain cancers in people living with HIV. What tests people might need to look for cancers early, and how these cancers are generally treated. It’s important to note that HIV is a complex topic that can affect a person’s health in many ways beyond their links to cancer.
How is HIV and AIDS related to cancer?
People living with HIV or AIDS can get cancer, just like anyone else. They are actually more likely to get some types of cancer than people who are not infected. Some types of cancer occur so often in people with AIDS that they are considered AIDS-defining conditions.
The reasons for the increased risk aren’t clear. It may be that some of these cancers are able to develop and grow more quickly because of a weakened immune system brought on by the infection itself. In other cases it may be because people with HIV infection are more likely to have certain other risk factors for cancer, such as being smokers.
“Many cancers are no more or less common in people with HIV infection or AIDS than in people who are not infected”
Some AIDS-defining cancers have become less common as more people have received effective anti-HIV treatment. As people with HIV infection have been living longer, they are also developing other types of cancer that are more common in older people. The use of treatments has also led to better cancer survival rates for people with HIV, as many people are now able to get full doses of chemotherapy and other standard cancer treatments, which may not have been possible in the past.
AIDS- defining cancers include:
· Kaposi sarcoma
· Non-Hodgkin lymphoma (especially primary central nervous system lymphoma)
· Invasive cervical cancer
Kaposi sarcoma (KS) is a cancer that develops from the cells that line lymph or blood vessels. It was once an uncommon cancer that mainly affected older men of Mediterranean, Eastern European, or Middle Eastern ancestry, organ transplant patients, or young men in Africa. But in the past few decades, most KS cases in the United States have been linked to HIV infection in men who have sex with men.
Non-Hodgkin lymphoma (NHL) is a cancer that starts in lymphoid tissue and may spread to other organs. It is more likely to occur in people with HIV infection than in people who are not infected, but most people with NHL are not infected with HIV. Fewer people with HIV are developing NHL since anti-HIV drugs have been in common use.
Cervical cancer is a cancer of the cervix, the lower part of the uterus (womb). Like Kaposi sarcoma, cervical cancer is strongly linked to infection with a virus. In this case, the virus is the human papilloma virus (HPV). HPV can be spread from person to person through skin-to-skin contact, including through sex.
Women living with HIV are at a high risk of getting cervical intraepithelial neoplasia (CIN). CIN is the growth of abnormal, pre-cancerous cells in the cervix. Over time, CIN can progress to invasive cervical cancer, in which the cancer cells grow into deeper layers of the cervix. CIN must be treated to keep it from invading. This is done by removing or destroying the outer layers of cervical cells. Untreated CIN is more likely to progress to invasive cervical cancer.
· Anal cancer
· Hodgkin disease (Hodgkin lymphoma)
· Melanoma skin cancer
· Liver cancer
· Lung cancer
· Mouth and throat cancers
· Testicular cancer
· Squamous cell and basal cell skin cancers
Some of these cancers have been linked to infections with different viruses. For example, anal cancer and some mouth and throat cancers are linked to infection with HPV, the same virus that causes cervical cancer. Liver cancer is known to be more common in people infected with the hepatitis B or C viruses. Some types of lymphoma have been linked with viral infections as well.
For some cancers, the higher risk in people who have HIV may be because of other risk factors these people are more likely to have, rather than the HIV infection itself. For example, mouth, throat, and lung cancers are strongly linked with smoking, which is more common in people with HIV, and the link with HIV becomes much weaker if smoking status is taken into account.
Cancers of the liver, mouth, and throat (as well as some other cancers) are linked with heavy alcohol use, which is also more common in people with HIV. Of course, as people with HIV are now living longer, they are also developing other cancers that are not clearly linked to HIV but are more common in older people, such as breast, colorectal, and prostate cancer.