Dr. Keith Roach: Kaposi’s sarcoma is caused by a herpes virus
Dear Dr. Roach: I have Kaposi’s sarcoma. I do not have HIV. I have had several surgeries. The surgeon said he must take a large area. Now some small lesions are appearing again on my foot. Is there another way to treat this? I also am having some GI issues. Could they be related? I am going to see a cancer doctor to see if he can shed some light on this.
Dear J.C.: Kaposi’s sarcoma is a cancer caused by a herpes virus, HHV-8. The lesions appear darkly colored; can be red, purple or brown; and most often appear on the feet. Kaposi’s sarcoma was classically described in older men, especially of Mediterranean or Central/Eastern European ancestry. It is also found in people with HIV, which is why you were tested.
KS can be treated surgically, but is typically treated locally with radiation, laser, liquid nitrogen or topical medications. When the disease is in many areas or is widespread, it is often treated with chemotherapy.
I am concerned about your description of GI issues, since KS may affect the stomach and intestines. This happens more in people with HIV and KS, but it can happen without HIV, as well. I think a visit to an oncologist is a good idea, since there are so many options for treatment, and repeated surgeries are no longer commonly used.
Dear Dr. Roach: I am a 50-year-old female. How accurate are the results of fecal blood tests?
In May, then July, I saw what looked like blood in my stool. My GP ordered the fecal blood test, three smears over three days. Results negative. Then in November I saw it again. My doctor said since the fecal test showed no blood, there is no blood.
My sister had colon cancer at age 45. I have had pre-cancerous polyps removed every three years for the past 10 years.
Can I trust the fecal blood test results?
Dear S.C.: The fecal occult blood test uses an enzyme that causes a color change in the presence of heme, a component of hemoglobin, the major protein in blood. Although the fecal blood results are pretty accurate, they can be erroneous in two ways: a false positive and a false negative.
A false positive means the stool test is positive when there is no blood. This can happen from eating raw vegetables (many types, especially turnips and radishes) and meat. A false negative can happen in the presence of large amounts of vitamin C, but more importantly, many lesions of the colon, including colon cancer, bleed only intermittently.
In my opinion, someone with a history like yours, including precancerous polyps and a family history of colon cancer, should have a colonoscopy as the screening test rather than stool cards.
Email questions to ToYourGoodHealth@med.cornell.edu.