The rate of non-AIDS-defining cancer is as much as three times higher in older adults with HIV compared to people without HIV. Some of the risk is associated with aging. The rates vary depending on the types of cancer. Rates are higher for Hodgkin’s lymphoma and anal, liver and lung cancer, while they are lower for breast, prostate, and colon cancers in older people living with HIV. However, several studies suggest that older adults with HIV seem to develop more advanced cancers. One reason for this might be that screening does not occur regularly in this population.
HIV AND THE CAUSES OF CANCER
The higher cancer risk for older people with HIV may be due to the direct effect of HIV on vulnerable tissues. The virus may attack the genes that cause cancer cells to grow. However, early HIV treatment can lead to a decrease in the rates of some cancers. But other cancers have not experienced this decline, so the reason is not clear. Older adults with HIV have also been more exposed to other cancer-causing viruses like hepatitis B and C, as well as HPV and Epstein Barr virus. Finally, tobacco use is a major cause of lung cancer as well as head and neck tumors. Unfortunately, older adults with HIV have higher rates of smoking compared to HIV-negative people.
What you can do with your doctor
TALK TO YOUR DOCTOR ABOUT YOUR CONCERNS AND THE NEED TO TEST FOR CANCER OFTEN
Regular cancer screenings are recommended for older adults with HIV because of the higher frequency of some cancers. Since there are no national guidelines for HIV patients, general age-specific screenings should be done. Annual anal and cervical pap smears are recommended for all people with HIV, regardless of whether they ever had anal sex.
What you can do yourself
MAKE SURE SCREENINGS ARE DONE
If you are diagnosed with cancer, learn all your treatment options. The treatment must meet the standard of care, including surgery, chemotherapy, or radiation. Also, there must be close coordination between your primary care physician and your oncologist.
These efforts can result in a satisfactory recovery and a return to normal. Older adults with HIV, however, are more vulnerable to complications from cancer treatment because of drug interactions and a weakened immune system.
Of course, prevention, including regular screening, can often detect cancer in its early stages. If you think your doctor is not screening often for cancers, then ask for the tests to be done more frequently.