Unsettling re-emergence of 'gay cancer'

[Newsjock]

Source: San Francisco Chronicle

San Francisco doctors have reported a cluster among gay men of unusual cases of Kaposi's sarcoma, the cancer-like skin disease whose disfiguring purple lesions were a terrifying signature of a bygone era of the AIDS epidemic.

All 15 patients under treatment for the condition are long-term survivors of HIV whose infections are firmly under control with antiviral drugs. So far, none of them appears to be in any danger.

The new cases of Kaposi's sarcoma have not been aggressive, invasive or lethal - the way the disease behaved in patients with uncontrolled HIV during the 1980s.

Still, the lesions are unsightly, difficult to treat and raise uncomfortable questions about what weaknesses might lurk in the immune systems of thousands of aging survivors of the epidemic.

The re-emergence of this classic AIDS illness in these outwardly healthy patients is an unsettling echo from the past and a warning that this 26-year-old plague still has the capacity to surprise.

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/10/11/MNEESOFRG.DTL&tsp=1

[silverojo]

1. Scary stuff

I hope this doesn't mean that the virus is beginning to develop an immunity to the drugs currently being used for AIDS survivors....

[aquart]

2. Tell me something else it could mean.

[LeftCoast]

3. This may be something a little different than what you are thinking

I work as an RN at the hospital closest to SF's Castro district. This place was literally Ground-Zero for the AIDS crisis and still today we treat large numbers of HIV+ patients. What I'm seeing is a group of patients who are developing diseases as a consequence of the medications. Increases in liver cancers, renal failure, etc.

Nobody has ever lived this long with compromised immune systems before. The long-term effects of that, not to mention long term exposure to the medications themselves, are unknown. In expediting these medications much of the long-term testing was rightly skipped.

In terms of the KS mentioned in the article, it could be related to the medication regime. I'm just speculating though. As far as HIV goes though, there are mutations out there and some of them sound scary. I have yet to hear much definitive information about these other strains though so I'm not sure what to think.

[Olney Blue]

7. Great, informative post.

Thanks!

[Hell Hath No Fury]

10. When I read this article this morning...

in the Chron, I flashbacked to the bad old days before the cocktail -- walking through the Castro and seeing the wraiths with KS, all the funerals, wondering who was going to be next. :cry:

I hope we've really put those days behind us...

[La Lioness Priyanka]

11. good point and thank you for sharing.

[roguevalley]

13. LeftCoast, you and your profession are my heros. Your folks cared

for all the people I loved more than my own life and did it with such decency, I will never forget it. My niece is an RN and I consider that next to being an angel. Take care and thank you for your service to the sick. Its an angelic calling.

[xchrom]

4. recommend -- and this points out the need for a vaccine.

long term, managed care for any disease like this will be fraught with real problems -- money, viral changes, new weaknesses to the immune system, etc.

[sutz12]

5. K & R for the AM crowd..

:kick:

[Sabriel]

6. Why must they resurrect that term?

It's not a gay thing! Everyone gets AIDS...children, women, and men.

[Freddie Stubbs]

8. True, but historically in this country it has affected gay men at a much higher rate than

the general population.

[Teaser]

9. When no on knew what it was

...it's the term that the gay community used for years

And it's being used for effect. It's a shocking term. A writer's job is to grab your attention.

Looks like it worked.

[girl gone mad]

17. I think because..

KS has been largely confined to the gay HIV+ population (and even some HIV-, IIRC). That's why it's been called the 'gay cancer'. Interestingly, before the early 80s, KS usually only appeared in elderly Sicilian men, so there is potentially a genetic component.

[CountAllVotes]

12. K&R

:dem: :kick:

[damntexdem]

14. Talk about a horrifying echo! I remember first reading the original KS story in SF in 1980.

[TrogL]

15. Why do they keep calling it 'gay cancer'?

http://en.wikipedia.org/wiki/Kaposi's_sarcoma

1. It's not cancer.

2. It's not associated with homosexuality.

Classic KS As originally described was a relatively indolent disease affecting elderly men from the Mediterranean region, or of Eastern European Jewish descent.<2><3>

Endemic KS Was described later in young African people, mainly from sub-Saharan Africa, as a more aggressive disease which infiltrated the skin extensively, especially on the lower limbs. This, it should be noted, is unrelated to HIV infection.<4><5>

Transplant Related KS Had been described, but only rarely until the advent of calcineurin inhibitors (such as ciclosporin, which are inhibitors of T-cell function) for transplant patients in the 1980s, when its incidence grew rapidly.<6><7>

Epidemic KS Was described during the 1980s as an aggressive disease in AIDS patients (HIV also causes a defect in T-cell immunity). It is over 300 times more common in AIDS patients than in renal transplant recipients. <8>

Note that HHV-8 is responsible for all varieties of KS.

[NYC]

18. Sarcoma:

sar·co·ma /sɑrˈkoʊmə/
Pathology.
any of various malignant tumors composed of neoplastic cells resembling embryonic connective tissue.


—Related forms
sar·co·ma·toid, sar·co·ma·tous /sɑrˈkoʊmətəs, -ˈkɒmə-/


sar·co·ma (sär-kō'mə)
n. pl. sar·co·mas also sar·co·ma·ta (-mə-tə)
A malignant tumor arising from connective tissues.




sar·co'ma·toid' (-mə-toid'), sar·co'ma·tous (-təs) adj.


sarcoma
1657, "fleshy excrescence," Medical L., from Gk. sarkoma "fleshy substance" (Galen), from sarkoun "to produce flesh, grow fleshy," from sarx (gen. sarkos) "flesh" (see sarcasm). Meaning "harmful tumor of the connective tissue" first recorded 1804.



sarcoma
noun
a usually malignant tumor arising from connective tissue (bone or muscle etc.); one of the four major types of cancer


sarcoma (sär-kō'mə)
Plural sarcomas or sarcomata (sär-kō'mə-tə)
A malignant tumor originating from mesodermal tissue, such as fat, muscle, or bone. Compare carcinoma.


sar·co·ma (sär-km)
n. pl. sar·co·mas or sar·co·ma·ta (-m-t)

A malignant tumor arising from connective tissues.

sar·coma·toid (-m-toid) or sar·coma·tous (-ts) adj.


sar·co·ma
: a malignant neoplasm arising in tissue of mesodermal origin (as connective tissue, bone, cartilage, or striated muscle) that spreads by extension into neighboring tissue or by way of the bloodstream —compare CANCER 1, CARCINOMA; TUMOR

[alfredo]

16. 1980 -I remember seeing those lesions on a fellow.

He was staying over at a neighbor's house. The neighbor said his friend is tired all the time and had those splotches on his skin. AIDS was not part of our vocabulary at the time. It wasn't much longer before I heard of "gay cancer." I then realized this poor fellow was dying.

I hope this is just an isolated occurrence.