HIV and Cancer: What is the Link?

Why do people with HIV seem to get cancer more often than people without HIV?

HIV itself plays a role in how cancer grows in people who are HIV-positive. HIV attacks the immune system, which protects the body from infections and disease. A weaker immune system is less able to fight off diseases, like cancer. People with HIV often have weakened immune systems, which means they will have a greater chance of getting cancer.

Here are some reasons why cancer seems to be more common among people with HIV:

  • People with HIV and AIDS are living longer. HIV medications are helping people with HIV live longer, healthier lives. But their immune systems do not get fully healthy. As people with HIV live longer, their chances of having other health problems, like cancer, increase.
  • HIV and other viruses work together. Having HIV and a weakened immune system makes is easier for other viruses to stay alive in your body. HIV and these other viruses work together to help cancer cells start growing. Once cancer starts in people with weakened immune systems, it grows faster than in healthy people. Some of these viruses are:
    • Hepatitis B and Hepatitis C
    • Herpes
    • Human Papillomavirus (HPV)
    • Epstein-Barr Virus (EBV)
  • Most people with HIV smoke cigarettes. About 60% to 70% of people with HIV smoke. Smoking is a risk factor for many different types of cancer. As people with HIV live longer and continue to smoke, they increase their risk of developing smoking-related cancers.

Is it true that HIV medications cause cancer?

No. There is no proof that HIV medications increase the risk of getting any type of cancer.

What is a "Risk Factor"?

A "risk factor" means anything that increases your chances of getting cancer. For example, smoking is a major risk factor for lung cancer. You can protect yourself from a lot of that risk by not smoking or by quitting smoking. Other risk factors are out of your control, like having a family history or genetic history of cancer. For example, if a parent or grandparent had cancer, your risk of getting that type of cancer will be greater.

Take action on some of the risk factors that you have some control over. If you have a family history of cancer ask your doctor or healthcare worker about ways to prevent that cancer and test for it.

What kinds of cancer do people with HIV usually get?

AIDS-related Cancers

In the past, people with HIV often got three types of cancer: Kaposi's Sarcoma, non-Hodgkin's lymphoma, and cervical cancer (in women). These are called AIDS-related cancers because they occur more often in people whose immune systems have been weakened by HIV/AIDS. Here are some facts about these cancers:

  • Kaposi's Sarcoma This cancer grows into reddish-purple patches on your skin that cannot kill you. It can be deadly if it gets in your throat or lungs. A herpes virus causes Kaposi's Sarcoma.
  • Non-Hodgkin's Lymphoma This cancer usually starts in the lymph glands, which are part of your immune system and help fight off disease. Lymph glands are mainly in the neck, under the arms, in the groin, and inside the belly. Epstein-Barr Virus is a risk factor for this cancer.
  • Invasive cervical cancer This affects the cervix, the entrance from the vagina to the uterus. Almost all women who get cervical cancer also have HPV. Having HIV and HPV makes cervical cancer grow faster.

Non-AIDS-related Cancers

People with HIV are getting more non-AIDS-related cancers. This happens even if they take HIV medications and have healthier immune systems. These cancers affect many different parts of the body. Smoking is a risk factor for many of these cancers. Here are some facts about non-AIDS-related cancers:

  • Lung Cancer Smoking is the main risk factor. Lung cancer among people with HIV has become more common since people began taking HIV medications and living longer. Quitting smoking, exercising, and keeping your immune system strong greatly lowers your lung cancer risk.
  • Hodgkin's Lymphoma is another cancer that occurs mainly in the lymph glands. It grows quickly in people who have weak immune systems.
  • Anal Cancer Men who have sex with men have a greater risk of anal cancer. Anal sex does not directly cause anal cancer. But, it can lead to getting HPV, which makes your risk for anal cancer much higher.
  • Liver cancer Having hepatitis B or hepatitis C and HIV makes your risk of liver cancer very high. Smoking, drinking alcohol, using street drugs, and sharing needles or other equipment to shoot drugs are also risk factors.
  • Other skin cancers Skin cancers other than Kaposi's sarcoma are becoming more common.

What can you do to lower your chances of getting cancer?

Two Ways to Beat Cancer: Healthy Living and Early Detection

You can lower your cancer risk a lot, and manage your HIV at the same time, by making healthy choices. Finding cancer in its early stages (early detection) and treating it right away can raise your chances of living longer with HIV. Cancer treatments can also be very hard on the immune systems of people with HIV. So, it is also important for people with HIV to not let cancer start growing (prevention) and find cancer in its early stages.

Healthy Living to Prevent Cancer

Quitting smoking is the biggest step to protecting yourself from cancer. If you quit smoking, you can greatly lower your risk of cancer of the mouth, throat, lungs, stomach, kidneys, liver, pancreas, and bladder. As soon as you stop smoking, your body starts to heal and your cancer risk drops. Ask your doctor about treatment and counseling to help you quit.

Take all your HIV medications on schedule. A stronger immune system is your best protection against many types of cancer. Take all your medications on schedule and try not to skip doses. HIV medications have helped to greatly reduce Kaposi's Sarcoma.

Protect yourself and others from HIV and other viruses. HIV, HPV, hepatitis and herpes are passed through sex or sharing needles or other equipment used to inject drugs. Use a condom the right way every time you have sex. Never share needles or drug works.

Eat healthy foods. You can lower your risk of cancers of the breast, prostate, stomach, colon, and rectum with a healthy diet.

  • Fruits and vegetables have lots of minerals, vitamins and fiber. Try to eat them five times a day - as part of every meal and as snacks.
  • Eat whole wheat bread, pasta, rice, and beans.
  • Eat lean meats like chicken and fish and low-fat dairy products, such as skim milk and cottage cheese.
  • Cook with canola oil or olive oil instead of butter.
  • Try to get your vitamins and minerals from healthy foods - not from pills, drinks, and powders.
  • Talk with your doctor or a nutritionist about what foods are right for you.

Get plenty of exercise, stay at a healthy weight. Regular exercise can lower your risk of getting some types of cancer.

  • Try walking, jogging, or riding a bike four or five days a week. A lot of things can count as exercise - as long as you move your body on a regular basis.
  • Do something you enjoy. That will make it easier to stick with it.
  • People with HIV or AIDS sometimes have trouble keeping enough weight on. Ask your doctor about how to exercise enough and eat enough to stay at a healthy weight.

Avoid drugs and alcohol. Drugs are not a direct cancer risk, but they can hurt your immune system and make it harder to stay healthy with HIV. You can lower your risk of mouth, throat, liver, and breast cancer (in women) by not drinking alcohol. If you have chronic hepatitis C and liver disease, don't drink at all.

Protect yourself from the sun. Wear sunscreen that is rated SPF 15 or higher. Wear a hat, sunglasses and clothing to protect you from the sun.

Finding cancer in its early stages (early detection)

Have regular medical check-ups. Talk with your doctor or health care provider about your cancer risk and problems to watch for. Ask about tests you can get even if you have no signs of cancer:

  • Pap smear for cervical cancer or anal Pap smear for anal cancer.
  • Mammogram for female breast cancer.
  • Colon/rectal exam.
  • Prostate exam for men over age 50.
  • Oral exam by a dentist every six months.

Know the warning signs of cancer and do self-exams. If you notice any of these warning signs, tell your doctor or dentist right away:

  • A sore that does not heal. Look for new growths on your skin or any changes in the size, color, or shape of moles or warts.
  • A lump or hardness in the skin, especially in female breasts and in the male testicles and groin area.
  • Oral exam: check the inside of your mouth, lips, gums, and tongue for sores, swelling or bleeding, white patches, scabs, or cracks.
  • Bleeding or loss of body fluids that is not normal.
  • Changes in your bowel or bladder habits.
  • A cough or a sore throat that lasts for a long time.
  • Heartburn or trouble swallowing that does not go away.

Staying Healthy and Preventing Cancer

HIV weakens the immune system and allows the growth of other viruses that can cause cancer. Scientists are working hard to figure out the links between HIV, other viruses, and cancer and to make medications that prevent and treat these diseases. In the meantime, do what you can to stay healthy and prevent cancer.

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