Some of the Neoplasm's found are
1. Cancer of Cervix - three cases
2. Hodkin's Lymphoma - one case
3. Cancer of Tongue - one case
4. Breast Cancer - one case
5. Non Hodkin's Lymphoma cases - four cases
6. Cancer of Rectum - one case
7. Cancer of Head & Neck - one case
8. Kaposi's Sarcoma - two cases
Problem of AIDS - Related Malignancies in Pure by Dr.Jayanth Joshi
ARM incidence is in increasing. 20 cases of ARM studied since 1990 from Hosptals of Pune.
The problems of their management were alaysed.
Following ARMS were encountered - KS - 2, NHL -6, Ca-ervix-5, Others-5, HD-2(associated)
WORLD INCIDENCE
10 to 30% wil develop kapois's Sarcoma
2 to 10% will develop NHL
1.3% will develop Cervical Cancer
HIV infected have > risk for other cancers like Anal cancer R.R. 31.7
Luekemias R.R. 11
H.D. R.R. 7.6
Softissue Sarcoma R.R. 7.2
Multiple Myeloma R.R. 4.5
CNS Cancer R.R. 3.5
Testicular Cancer R.R. 2.9
Lung adenoca R.R 2.5
CDC 18,000 cases of HIV Jan to June 94 & July to Dec 1996, K.S. < from 53.4 to 10.3
and also MACS (Multicntre AIDS Cohort Study) from 1996 & 1997. CNS Lyphoma < from
8.5 to 0.9/1000 patient years.
Cause: HIV induce an immunosuppressed host in which Oncogenic Viral
Infection and Oppotunistic Neoplasia can developrelatively unchecked and it can serve to
stimulate the immune system to secrete a cytokines that promote cellular proliferation and
Oligoclonal Expressions of Cells infected with a variety of known Oncogenic Viruses.
Molecular Interactions between HIV related proteins(or factors induced by HIV) and Genomic
sequences in some of these viruses may modulate their Oncogenic potential.
Screaning: CDC recommended Cytologic screaning as part of intial
evolution when HIV seropositivity is diagnosed (Pap Smear). If initial pap smear is normal
additional evalution with in 6 months. Then every year. If intial or follow-up pap smear
shows squamous celluar changes another pap smear should be collected with in 3 months. If
intial or follow-up pap swar shows squamous intraepithelial lesions of atypical squamous
cells of undetermined significane then colposcopically directed biopsies. Pap smear every
1 to 2 years beginning in early HIV disease would result in an incremental
cost-effectiveness ratio of $13,000 to $16,000 per quality adjusted life year saved and
thus offer quality adjusted life expectancy benefits at a cost comparable with other
accepted clinical preventive interventions.
Less cancer cases in HIV/AIDS patients in India may be due to
1. Fewer years of HIV positivity period
2. Fast progression of AIDS
3. Thinner / Lesser Nourished Indian population.
4. Fewer cases being investigated.
Presentaion of HIC positive is detected accidentally while investigating. HIV Positive
cases fair poorly for Anti-Cancer treatment because of advanced disease, faster
progression of cancer, poor hematologica status, concurrent infections and poorer
supportive measures available. Treatments offered are similer to other cancer's like
surgery, Radiation therapy, Chemotherapy and Anti Retroviral treatment apart from
supportive treatment. Dr. P.S.V.Sathyanarayana has given 1. AVALMIC-I, 2. AVALMIC-II, .
KAPHAYOGA, 4. MEDHAMRUTHA, Manufactured by G.P. Pharmaceticals.
Most of the cases presented in very poor general condition which when did not improve
routean supportive treatment was investigated for HIV. On dectection of HIV concurrent
positivity further supportive case was given. Certain patients improved considerably. Due
to various socio-economic factors care and follow-up could not be made indefinately.
Encouraging results are present till last follow-up of most of the cases.
Patients improved with the above treatment and results are encouraging. There are no side
effects during the combined treatment(both Allopatheic and Ayurvedic).
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