Kaposi Sarcoma: Surgery and Other Local Treatments

Surgery and other types of local treatment can sometimes be used to remove or destroy Kaposi sarcoma (KS) lesions. Local treatments are those that treat only one area of the body. They don't treat the whole body.

Local treatments are sometimes used to treat one or more KS lesions that are grouped in a small part of the body that's visible, such as the face. The goal of this treatment is to remove or destroy the lesions to help you look and feel better.

The type of treatment done depends on your overall health, where the lesion is, and how fast the KS is growing and spreading. Local treatments don't keep new lesions from forming in other parts of the body.

Several types of local treatments can be used for KS lesions.

Removing the lesions with surgery is sometimes an option. There are two main ways to remove KS lesions:

• Simple excision. To do this, the skin is numbed, and the lesion along with a small edge of healthy skin around it is removed with a surgical knife.
• Curettage and electrodessication. In this procedure, the skin is numbed, and the lesion is removed with a sharp, spoon-shaped tool (curette). An electric current is then applied to the area to stop bleeding and destroy any remaining cancer cells.

For this treatment, very cold liquid nitrogen is put on the lesion to freeze and kill the cancer cells. This is most often used to treat small lesions on the face. It can be repeated if needed.

PDT involves putting a liquid medicine right on the lesion. It collects in the cancer cells and makes them more sensitive to some kinds of light. The cells are given time to absorb the medicine. Then a special light is aimed at the lesion. The light activates the medicine, which kills the cells. This treatment can make the treated area very sensitive to sunlight for a time. So it's very important to keep the area covered up.

This treatment uses a type of medicine called a retinoid, which is related to vitamin A. You put the medicine right on the lesion 2 to 4 times a day. It can shrink the lesion over a few months. The retinoid used most often is alitretinoin.

Imiquimod is another medicine that's put onto the lesion to shrink it or even make it go away. It's put on 3 times a day for about 6 months.

A drawback of topical treatments is that they can cause the area to become red and swollen. This limits their use.

Some KS lesions can be treated by using a needle to put a small amount of chemotherapy (chemo) right into the lesion. The chemo medicine most often used is called vinblastine. It can cause the lesion to shrink over time. This treatment might need to be repeated. Side effects can include swelling, pain, and blistering.

High-energy X-rays or other types of radiation can be used to treat some KS lesions. This is especially true if they're larger and unlikely to be helped by other local treatments.

If you have any questions about your treatment, talk with your health care team. They can help you know what to expect before, during, and after local treatments.