AIDS-Related Cancers

What are AIDS-related cancers?

People living with HIV are much more likely to get certain types of cancer than people without HIV. Certain kinds of cancer are called AIDS-defining cancers or AIDS-defining malignancies. This means when people with HIV develop one of them, their HIV infection has progressed to AIDS. AIDS-defining cancers are:

• Kaposi sarcoma

• Aggressive B-cell non-Hodgkin lymphoma (NHL)

• Cervical cancer

Note: People who don't have HIV can also develop these types of cancer.

People with HIV or AIDS are also more likely to develop other cancers called non–AIDS-defining cancers (NADCs). While these cancers are more likely in people living with HIV, they’re not a sign that HIV has progressed to AIDS. These cancers include:

• Head and neck cancer

• Anal cancer

• Lung cancer

• Liver cancer

• Hodgkin lymphoma

• Skin cancer (all types)

• Testicular cancer

• Penile cancer

• Colorectal cancer

What causes AIDS-related cancers?

The cause of cancer in people living with HIV isn't clearly understood. But when a person becomes infected with HIV, we know that their immune system doesn’t work as well as it should. This puts them at higher risk for infections. It makes their body less able to control viral growth, and some viruses are linked to cancer. For instance, HPV (human papillomavirus) infection has been linked to certain head and neck cancers, anal, and cervical cancer, as well as many other kinds of cancer. Lymphoma has been linked to viral infections, too.

Who is at risk for AIDS-related cancers?

Having HIV or AIDS raises your risk for AIDS-related cancers. In fact, Kaposi sarcoma is rare in people who don’t have HIV.

But AIDS-related cancers are becoming less common. This is likely because people in the U.S. are getting antiretroviral therapy or anti-AIDS medicines. These allow the immune system to fight the viruses that cause many of these cancers.

What are the symptoms of AIDS-related cancers?

The symptoms depend on the type of cancer:

• Kaposi sarcoma. This cancer causes purple or brown spots (called lesions) on your skin or inside your mouth. It can also affect internal organs and tissues, like your lungs, digestive tract, and lymph nodes. It can cause fever, cough, swollen lymph nodes, stomach pain, and weight loss.

• Non-Hodgkin and Hodgkin lymphoma. Common symptoms are fever, unexplained weight loss, night sweats, swollen lymph nodes, and a feeling of fullness in the chest. Lymphoma can also occur in the brain. This can cause memory loss, confusion, seizures, and extreme tiredness (fatigue).

• Cervical cancer. This cancer often doesn’t cause symptoms until it’s grown and spread into nearby tissues. Then it may cause abnormal vaginal bleeding or discharge, pain during sex, and longer or heavier periods.

• Anal cancer. Symptoms may include pain, bleeding, itching, a lump in the anal area, or a change in bowel habits.

• Lung cancer. Symptoms can include shortness of breath or severe coughing, which may bring up blood. Other signs are chest pain, hoarse voice, fatigue, and weight loss.

• Head and neck cancers. There are many different kinds of cancer that start in the head and neck. Some common symptoms are mouth sores, headaches, and neck, throat, face, jaw, tooth, or ear pain. Abnormal bleeding in the mouth or from the nose, voice changes, and vision problems are other symptoms.

• Liver cancer. This cancer can cause belly pain and swelling, yellowing of the skin and eyes (jaundice), weight loss, and tiredness.

• Testicular cancer. Symptoms are a lump or swelling in a testicle, ache or heaviness in the scrotum, or pain or numbness in a testicle.

• Skin cancer. These cancers cause changes on your skin. It could be a new growth, a mole that changes, or a sore that doesn't heal.

The symptoms of AIDS-related cancers can look like other health conditions. Make sure you see a healthcare provider for a diagnosis.

How are AIDS-related cancers diagnosed?

If you have HIV, you likely see your healthcare provider regularly. During these visits, you'll be asked about your health, and a physical exam will be done. This allows your provider to watch for things like infection and other problems, including cancer.

If your provider thinks you may have an AIDS-related cancer, you'll need certain tests. These depend on the type of cancer you might have. They may include:

• Biopsy. This is when a tiny piece (sample) is taken from the lesion or lump. The sample is sent to a lab and tested for cancer cells.

• Blood tests. These can help diagnose some cancers and get an idea of your overall health.

• Imaging tests. X-rays, CT scans, PET scans, or MRIs create images of the inside of your body. They may be used to look for and help diagnose different cancers.

• Other tests. Depending on your symptoms, you may need other tests. For instance, a woman’s healthcare provider may do a Pap test to check for cervical cancer. A lumbar puncture (spinal tap) may be done to look for lymphoma cells in the fluid that surrounds and cushions the brain and spinal cord (called the CSF or cerebrospinal fluid).

Part of diagnosing cancer is called staging. Staging is the process of finding out how big the cancer is and if it has spread. Staging also helps to decide on the best treatment options. There are different staging systems used for different cancers. Most use a scale of stage 1 to stage 4, where a stage 4 is cancer that has spread to other parts of the body. Talk with your healthcare provider about the stage of your cancer and what it means.

How are AIDS-related cancers treated? 

Treatment depends on the type of AIDS-related cancer you have and how far it has spread in your body. You may need 1 or more of these treatments:

• Surgery. Removing the tumor may be an option for some cancers.

• Chemotherapy (chemo). These medicines can kill cancer cells or stop them from growing.

• Immunotherapy. This treatment uses medicines that help the immune system focus on and kill cancer cells while causing little harm to healthy cells.

• Targeted therapy. These medicines focus on changes in the cancer cells to kill them while limiting damage to healthy cells.

• Radiation. High-energy X-rays or other types of radiation can help shrink or kill cancer cells.

Treating HIV infection itself is an important part of therapy. You will be given antiretroviral treatment (ART) to control the virus. This can help reduce the side effects (such as infection) from other treatments and improve your chance of recovery.

What are possible complications of AIDS-related cancers?

Possible complications and side effects depend on the type and stage of the cancer, as well as the treatments used. They can include:

• Greater risk of infection

• Easy bleeding and bruising

• Tiredness

• Nausea and vomiting

• Diarrhea

• Poor appetite

• Mouth sores

• Hair loss

• Higher risk of other cancers in the future

• Changes in the way your body looks and works

Your healthcare providers will talk with you about the risks and side effects related to your treatment. Ask your provider what you should watch for, when to report symptoms, and what can be done to help manage or prevent side effects.

What can I do to prevent AIDS-related cancers?

You can help reduce your risk of AIDS-related cancers by doing these things:

• Get regular checkups.

• Take your antiretroviral therapy correctly to keep your immune system strong.

• Limit alcohol.

• Don’t smoke and stay away from secondhand smoke.

• Practice safe sex. Limit your sex partners and use condoms.

• Find out your hepatitis status. Some types of hepatitis can be treated.

• Know that the virus linked to Kaposi sarcoma is spread through saliva. Try to limit deep kissing and other contact with your partner’s saliva.

• Talk with your healthcare provider about the HPV vaccine. HPV infection is linked to many of these cancers. The HPV vaccine might help reduce risk in people who are not already infected with HPV.

• Follow a healthy, plant- and whole grain-based diet.

• Get to and stay at a healthy weight.

• Exercise.

• Protect your skin when you're in the sun.

Get tested for cancer in these ways:

• Women should get regular pelvic exams and Pap tests. This helps your healthcare provider find and treat abnormal cells before they turn into cancer.

• Talk with your provider about anal Pap test screening. This tests cells from the anus. It's done for both women and men at high risk for anal cancer. While the research is still unclear and not all providers agree, this may help find anal cell changes so they can be treated before they become cancer.

How do I manage AIDS-related cancers?

You will need follow-up care during and after cancer treatment to:

• Check on your response to treatment

• Manage the side effects of treatment

• Look for the return or spread of cancer

• Keep HIV under control

When should I call my healthcare provider?

Call your healthcare provider if you have:

• Symptoms that get worse

• New symptoms

• Side effects from treatment

Key points about AIDS-related cancers

• People living with HIV or AIDS are much more likely to get certain types of cancer than people without HIV or AIDS.

• AIDS-defining cancers include Kaposi sarcoma, aggressive B-cell non-Hodgkin lymphoma, and cervical cancer. Other cancers linked to HIV/AIDS are head and neck, anal, lung, testicle, skin, and liver cancers, as well as Hodgkin lymphoma.

• HIV affects the way the immune system works. This may be what increases the risk for certain cancers.

• Taking antiretroviral therapy can help reduce your risk of these cancers.

• A biopsy and imaging tests are often needed to diagnose cancer.

• Treatment depends on the type of cancer and may include surgery, radiation, chemotherapy, immunotherapy, and targeted therapy. Anti-HIV medicines are a key part of treatment and recovery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.