You may not have known this, but HIV/AIDS is a cancer-causing agent and can put people living with HIV (PLWH) at risk for cancer…
This is a fact that the Cancer Association of South Africa (CANSA), National Department of Health, National Cancer Registry (NCR) and Southern African HIV Clinicians Society are highlighting this World AIDS Day (1 December).
“With just over seven million South Africans living with HIV, it’s important that the increased risk of cancer in PLWH is recognised as a real concern,” says Dr Melissa Wallace, Head of Research at CANSA.
“Dedicated antiretroviral therapy (ART) adherence, adopting a healthy lifestyle, regular exercise and cutting out tobacco and alcohol are resulting in PLWH living a healthy and full life. CANSA wants to encourage PLWH to reduce their cancer risk and know the signs and symptoms of the most common cancers affecting PLWH as early detection improves treatment outcomes.”
“Our recent study examined national cancer trends and excess cancer risk in people living with HIV compared to those who are HIV-negative. The study found that people living with HIV are at higher risk of AIDS-defining cancers namely, Kaposi sarcoma, non-Hodgkin’s lymphoma and cervical cancer,” says Dr Elvira Singh, Head of the NCR
“They’re also at increased risk of conjunctival cancer and human papillomavirus (HPV) related cancers which include penile, anal and vulvar cancer, compared to HIV-negative patients. Squamous cell carcinoma of the skin has also been found to be HIV-associated. The risk of Kaposi sarcoma has declined as antiretroviral therapy (ART) became available. However, the risk of conjunctival cancer and HPV-related anogenital cancers (cervical, anal, vulvar and penile cancers) continues to rise, despite the widespread availability of ART.”
What can people with HIV/AIDS do?
“To lower personal risk of cancer and to promote early detection, people living with HIV should initiate ART early and adhere to ART to lower the risk of Kaposi sarcoma and non-Hodgkin’s lymphoma,” says Dr Wallace.
“Early initiation of ART has been enabled by the Universal Test and Treat policy in South Africa which allows for the initiation of ART regardless of CD4 count. Additionally, cervical cancer screening in HIV-positive women should be done at HIV diagnosis, and every three years (yearly if a screening test is positive) according to the recommendations of the SA Cervical Cancer Policy.”
Common symptoms of HIV related cancers include:
- Kaposi sarcoma: slightly elevated purple/pink (on white skin); brown/black (on darker toned skins), red blotches or bumps anywhere on the skin or in the mouth and / or throat; swelling of the legs – caused by a blockage of the lymphatic system
- Cervical cancer: may have no symptoms in early stages; increased vaginal discharge; maybe foul-smelling discharge; pain or bleeding during sexual intercourse.
- Hodgkin’s and non-Hodgkin’s lymphoma: painless; swollen lymph nodes in the neck; armpits or groin; persistent fatigue, fever, night sweats; unexplained weight loss.
- Conjunctival cancer: a white, painless, progressive growth on the surface of the eye; may have associated photophobia, redness of the eye, irritation and foreign body sensation.
- Anal cancer: may have no symptoms in early stages; blood or mucus in stools (faeces) or on toilet paper; itching; discomfort or pain around the anus; a feeling of fullness, discomfort or pain in the rectum; a lump near the edge of the anus; ulcers around the anus.
- Vulvar cancer: thickening/roughness of the skin of the vulva; itching, pain or burning; a lump or open sore on the vulva; bleeding or discharge not related to the normal menstrual period.
- Penile cancer: a growth or sore on the penis that does not heal in four weeks; bleeding from the penis or foul-smelling discharge from under the foreskin; thickening or discolouration of the skin on the penis.
- Squamous cell carcinoma of the skin: a wart-like skin growth, or a persistent, scaly red patch with irregular borders that may bleed easily; an open sore that persists for weeks; a raised growth with a rough surface and a central depression.
CANSA encourages screening as early diagnosis allows more effective treatment.
It’s Care Centres country-wide offer Pap smears, a liquid-based cervical cancer screening test for early diagnosis. Further screenings include Clinical Breast Examinations, skin examinations using a FotoFinder to examine moles and Prostate Specific Antigen (PSA) blood tests to assist detecting prostate abnormalities, all at very affordable rates.
For more information, visit https://www.cansa.org.za/cansa-care-centres-contact-details
Sources: CANSA & Dhokotera, T., Bohlius, J., Spoerri, A., Egger, M., Ncayiyana, J., Olago, V., Singh, E. and Sengayi, M., 2019. The burden of cancers associated with HIV in the South African public health sector, 2004–2014: a record linkage study. Infectious agents and cancer, 14(1), p.12.
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