Cancer screening exams can help find Kaposi sarcoma at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose Kaposi sarcoma early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

Once sarcoma has been diagnosed, each patient meets with dedicated medical, surgical and radiation oncology experts – all in one day – who sub-specialize in treating sarcoma patients, so that a precise treatment path can be designed and begun right away.

Additionally, the OSUCCC – James partners with Nationwide Children’s Hospital and the OSU Wexner Medical Center to offer world-renowned sarcoma expertise in one of the top integrated pediatric and adult sarcoma care programs anywhere in the country.  

Diagnosing Kaposi Cancer

If you are at high risk for Kaposi sarcoma or observe any unusual skin lesions, your OSUCCC -  James specialists will conduct a full physical examination, record your medical history and gather information about any additional symptoms, lifestyle and risk factors you may have.

The following tests or procedures can help detect and diagnose Kaposi sarcoma:

Biopsy

A sarcoma pathologist removes a small piece of tissue to analyze under a microscope for signs of cancer. There are several ways to obtain a biopsy sample for diagnosing Kaposi sarcoma:

Incisional Biopsy

The doctor removes a tissue sample during a surgical procedure.

Core Biopsy

The doctor uses a wide needle to remove a small sample of tissue.

Excisional Biopsy

A surgeon removes an entire lump or area of abnormal tissue.

Removed tissue will undergo other tests following biopsy to help the OSUCCC – James experts classify the type and subtype of soft tissue sarcoma. These tests include:

Immunohistochemistry

This test uses dye on proteins called antibodies to identify certain antigens in the tissue sample. Antigens are any substance that causes a response in the body’s immune system against that substance. Antigens include toxins, bacteria, chemicals, viruses or other substances that come from outside the body.

Light & Electron Microscopy

Changes in cells that indicate cancer types are evaluated under high-powered microscopes.

Cytogenetic Analysis

This test analyzes the cells to identify changes in the chromosomes.

Fluorescence in Situ Hybridization (FISH)

This laboratory test analyzes the cells’ genes or chromosomes. A special light and fluorescent dye cause certain genes or specific areas of chromosomes to light up when pieces of lab-created DNA attach to them.

Flow Cytometry

Flow cytometry measures numbers and proportions of cells in a tissue sample and can determine characteristics of cells, such as their shape, size and presence of tumor markers. Tumor markers are substances that indicate certain cancers.

Chest X-ray

This exam uses X-rays to produce images of the organs and bones inside your chest, especially the lungs. A chest x-ray can find Kaposi sarcoma in the lungs.

Endoscopy

An OSUCCC – James expert uses a thin, flexible tube (called an endoscope) with a specialized tool on it to remove tissue samples for examination. The endoscope is inserted through the mouth or nose or through a small incision into the esophagus and stomach. This test can help find Kaposi sarcoma lesions in the gastrointestinal tract.

Bronchoscopy

A bronchoscope is a small, flexible tube with a tiny camera on the end of it. An OSUCCC – James specialist inserts the tube through the nose or mouth and into the lungs while the patient is under light or general anesthesia. The physician can also use the bronchoscope to take a small tissue sample for biopsy.

Stages of Kaposi Sarcoma

Staging Kaposi sarcoma is one of many ways that your OSUCCC – James sub-specialists can design the best treatment options for your specific cancer.

Stages take into account the extent of the disease, how much the patient’s immune system may be compromised and the presence or absence of any symptoms.

Tumor (T)

Good Risk

(0): The cancer is confined to the skin and/or lymph nodes and/or to minimal oral disease.

Poor Risk

(1) includes any of the following: The tumor is associated edema (swelling) or ulceration There is extensive oral Kaposi sarcoma There is gastrointestinal Kaposi sarcoma Kaposi sarcoma is in other non-nodal viscera (organs)

Immune System (I)

Good Risk

(0) CD4 cell count >= 200/microL

Poor Risk

(1) CD4 cell count <200 per cubic millimeter

Systemic Illness (S)

Good Risk

(0) includes any of the following: There is no history of opportunistic infections or thrush There are no ‘B’ symptoms (unexplained weight loss, fever, night sweats, greater than 10 percent involuntary weight loss, or diarrhea persisting more than 2 weeks) Performance status is greater than or equal to 70 Poor Risk

(0)

There is history of opportunistic infections or thrush ‘B’ symptoms are present Performance status less than 70 There are other HIV–related illnesses (e.g., neurological disease or lymphoma)

(Source: National Cancer Institute) (Link to: www.cancer.gov)

If you’ve been diagnosed with Kaposi sarcoma, would like a second opinion or would like to speak with a sarcoma specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

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Columbus, Ohio 43210

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