CANSA Encourages People Living with HIV to Know their Cancer Risk
On World AIDS Day (1 December), CANSA, the National Department of Health, National Cancer Registry (NCR) and the Southern African HIV Clinicians Society highlight that the human immunodeficiency virus (HIV) is a cancer-causing agent and can put people living with HIV at risk for cancer.
Dr Melissa Wallace, Head of Research at CANSA, says “With just over 7 million South Africans living with HIV, it’s important that the increased risk of cancer in people with HIV (PLWH) is recognised as a real concern. 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.”
Dr Elvira Singh, Head of the NCR elaborates, “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. 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 ano-genital cancers (cervical, anal, vulvar and penile cancers) continues to rise, despite widespread availability of ART.”
Wallace adds, “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. Early initiation of ART has been enabled by the Universal Test and Treat policy in South Africa which allows for initiation of ART regardless of CD4 count. Additionally, cervical cancer screening in HIV-positive women should be done at HIV diagnosis, and every 3 years (yearly if 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 tone skins); or 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 mucous 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; 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 4 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.
* 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.
CANSA offers a unique integrated service to the public and to all people affected by cancer. CANSA is a leading role-player in cancer research and the scientific findings and knowledge gained from our research are used to realign our health programmes, as well as strengthen our watchdog role to the greater benefit of the public. Our health programmes comprise health and education campaigns; CANSA Care Centres that offer a wide range of care and support services to those affected by cancer; stoma and other clinical support; medical equipment hire, as well as a toll-free line to offer information and support. We also supply patient care and support in the form of 12 CANSA Care Homes in the main metropolitan areas for out-of-town cancer patients and CANSA-TLC lodging for parents and guardians of children undergoing cancer treatment.
Visit www.cansa.org.za or contact the nearest CANSA Care Centre, call CANSA toll-free 0800 22 66 22 or email: firstname.lastname@example.org. In addition to online resources and Facebook support groups, CANSA offers multi-lingual support on WhatsApp: 072 197 9305 for English and Afrikaans and 071 867 3530 for Xhosa, Zulu, Sotho and Siswati. Follow CANSA on Twitter: @CANSA (http://www.twitter.com/CANSA), join CANSA on Facebook: CANSA The Cancer Association of South Africa and follow CANSA on Instagram: @cancerassociationofsouthafrica and LinkedIn.