Neoplasms in the acquired immune deficiency syndrome: the multidisciplinary approach to treatment

Associated with the acquired immune deficiency syndrome (AIDS) is a wide spectrum of opportunistic infections and secondary cancers. Foremost among the cancers is an aggressive form of Kaposi's sarcoma (KS) that was rarely seen in the United States before 1981. The pathogenesis of this AIDS-related KS is obscure, and its prognosis is mainly related to the patient's immune status and history of opportunistic infections. Treatment modalities include local or regional radiotherapy, cytotoxic chemotherapy, and interferon therapy. Other cancers associated with AIDS include non-Hodgkin's lymphomas that are typically high-grade, diffuse B cell neoplasms occurring at unusual sites, frequently in the brain. Management of the patient with an AIDS-associated neoplasm requires a multidisciplinary team that includes specialists in infectious diseases, dermatology, radiotherapy, psychiatry, and nutrition, as well as oncology.