Patient can’t accept Doc’s good news

DEAR DR. GOTT: I am uncertain how familiar you are with AIDS but I sure am hoping you can help. I’ve had HIV tests but they have all come back negative. From what I have been told and have read, one can still have AIDS that eventually turns into cancer. Can you tell me how this is diagnosed?

I have asked my physician about it and he had blood work drawn from me but he hasn’t said anything. I am certain that I have it and nobody will listen to me. I feel like I am losing my mind. There are things I need and want to do before I buy the farm. Please help!?! If you have any questions, please let me know. Thank you.

DEAR READER: Being HIV positive doesn’t automatically cause cancer; however, the condition does play a role in how cancer grows. HIV attacks and weakens the immune system that ordinarily is successful in protecting the body from infection and disease. A weakened immune system is essentially less able to fight diseases such as cancer, implying the HIV positive individual will be at increased risk of developing some of these diseases. The reasons include the fact that medication for HIV is allowing people to live longer and, as we age, the risk of being diagnosed with cancer grows. Between 40% and 70% of all people who test positive for HIV are smokers. Smoking increases a person’s risk of acquiring cancer. It appears that HIV and other viruses such as hepatitis B and C, HPV (human papillomarivus) and herpes also work together in the body to create a compromised immune system, making cancer grow faster than it would do in a healthy individual.

There are three specific forms of AIDS-related cancer linked with individuals who test HIV positive. They are non-Hodgkin’s lymphoma that ordinarily begins in the lymph glands; Kaposi’s sarcoma which develops into purple/red patches on the skin which, in some cases can be caused by a herpes virus; and invasive cervical cancer which, as the name states, affects the cervix. The primary cause of cervical cancer is HPV. The combination of HIV and HPV makes cervical cancer grow at a faster rate.

Let’s take a moment to briefly touch on the three forms I have mentioned:

Lymphoma is a term given to cancers that develop from cells of the lymphatic system. There are more than 30 forms of non-Hodgkin’s which is likely why it is the fifth most common type of cancer in the United States. Non-Hodgkin’s develops in the lymphatic system from cells known as lymphocytes. Primary lymph glands are in the neck, groin, under the arms, and in the abdomen. This form of cancer can develop in bone marrow, the spleen, digestive tract, lymph nodes (of which there are over 500 throughout the body), and thymus (an organ located at the base of the neck and involved with the development of cells of the immune system). Symptoms include persistent fatigue, night sweats, unexplained weight loss, swollen lymph glands, an itchy rash, cough, and more. Keep in mind that these symptoms can found in other diseases, as well.

Kaposis sarcoma lesions generally affect the skin and resemble bruises that are not associated with pain, nor do they itch. When isolated to areas of the skin, the condition is not life-threatening. When it forms in the intestinal tract, internal organs, brain, or lungs, the consequences can be extremely serious and even fatal. The only method of diagnosis is through biopsy.

Cervical cancer is usually without symptoms in its early stages. As the disease advances, a woman may experience persistent pelvic pain, abnormal vaginal bleeding or discharge and pain during intercourse — all symptoms that could be unrelated to cancer. If symptoms are present, a woman should see her gynecologist or primary care physician for a PAP test to determine if a problem exists.

Treatment for HIV/AIDS-related cancers will vary and is based on the type of cancer diagnosed. Common treatment methods include chemotherapy, radiation and surgery.

You haven’t indicated you have any symptoms suggesting a problem, so if you can’t accept your doctor’s good news, perhaps you should be seeing another physician for a second opinion or even a therapist to determine why you are so convinced you have HIV/AIDS. Either believe the good news or remain consumed with the thought something could be wrong. Rather than buy the farm, why not accept the results and get on with your life? Personally, I think the latter is a far better way to go.