What are AIDS-related cancers?

When people with HIV develop certain cancers, healthcare providers consider their HIV infection to have progressed to AIDS. These cancers are called AIDS-related cancers or AIDS-related malignancies.

People who have AIDS are much more likely to get certain types of cancer than people without the disease. They include Kaposi sarcoma, non-Hodgkin lymphoma (NHL), and cervical cancer.

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

• Head and neck cancer

• Anal cancer

• Lung cancer

• Liver cancer

• Hodgkin lymphoma

What causes AIDS-related cancers?

When a person becomes infected with HIV, the immune system doesn’t work as well as it should. As a result, the person is at higher risk for infections and long-term (chronic) diseases such as cancer.

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.

AIDS is linked to a higher risk for certain types of cancer. But AIDS-related cancers have become less common. This is likely because people in the U.S. are getting antiretroviral or anti-AIDS medicines. 

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 (lesions) on your skin or inside your mouth. It can also affect internal organs and tissues, such as your lungs, digestive tract, and lymph nodes. It can cause fever, swollen lymph nodes, and weight loss.

• Non-Hodgkin lymphoma. Common symptoms are fever, unexplained weight loss, sweating at night, swollen lymph nodes, and a sense of fullness in the chest. Lymphoma in the brain and spinal cord is common. This can cause memory loss, confusion, seizures, and extreme tiredness (fatigue).

• Cervical cancer. This cancer 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 in the anal area, bleeding, itching, a change in bowel habits, or a lump in the area.

• Lung cancer. Symptoms can include severe coughing, which may bring up blood. Other signs are chest pain, trouble breathing, fatigue, and weight loss.

• Head and neck cancers. There are many different kinds of cancer that start in these areas. Some common symptoms are mouth sores, headaches, and neck, throat, face, tooth, or ear pain. Abnormal bleeding in the mouth or from the nose may also occur.

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

• Hodgkin lymphoma. Symptoms are the same as for non-Hodgkin lymphoma.

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 will be asked about your health and may have a physical exam. This allows your provider to watch for things such as infection and other problems, including cancer.

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

• Biopsy. Your healthcare provider may take a sample (small piece) of tissue from the lesion or lump. The sample is checked with a microscope to see if there are cancer cells in it.

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

• Imaging tests. X-rays and CT or MRI scans 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 example, 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.

Part of diagnosing cancer is called staging. Staging is the process of seeing if the cancer has spread, and where it has spread. Staging also helps to decide on the best treatment options. There are different staging systems used for different cancers, but most range from stage 1 to stage 4, where a stage 4 is cancer that has spread to 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 what type of AIDS-related cancer you have and how far it has spread in your body. You may need one or more of these treatments:

• Anti-HIV medicines. These can help control the HIV virus. They may help reduce the side effects (such as infection) from other treatments and improve your chance of recovery.

• 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 helps the immune system focus on and kill cancer cells while causing little harm 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 also an important part of therapy. You will be given antiretroviral treatment (ART) to control the virus.

What are possible complications of AIDS-related cancers?

Possible complications depend on the type and stage of the cancer, as well as the treatments used. Complications 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

Talk with your doctor about what you should watch for and what can be done to help prevent complications.

What can I do to prevent AIDS-related cancers?

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

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

• Don’t smoke and stay away from secondhand smoke. This can lower your risk for lung cancer and some other cancers, too.

• Limit your sex partners and don’t smoke. This can lower the risk of cervical cancer.

• Find out your hepatitis status. Liver cancer is linked to cancer in people with HIV infection. 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 some of these cancers. The HPV vaccine might help reduce risk in people who are not already infected.

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 develop into cancer.

• Talk with your provider about anal Pap test screening. This is a test of cells from the anus. It is done for both women and men. While the research is still unclear and not all doctors 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 treatment to:

• Check on your response to the treatment

• Manage the side effects of treatment

• Look for the return or spread of cancer

• Keep the 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 who have AIDS are much more likely to get certain types of cancer than people without the disease.

• These types of cancer include Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer. Other cancers linked to AIDS are head and neck, anal, lung, 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 used to diagnose cancer.

• Treatment depends on the type of cancer and may include anti-HIV medicines, surgery, radiation, and chemotherapy.

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 instructions 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 provider if you have questions.