Advanced BCC: Questions to ask your healthcare team

While basal cell carcinoma (BCC) is the most common type of skin cancer, each case of BCC is different, and treatment will vary from person to person. This is what is referred to as individualized treatment or personalized medicine, and it is the standard of care for many types of cancers. With this approach, a person being treated for BCC will work with a multidisciplinary team of healthcare providers who oversee different aspects of treatment.

Because advanced BCC is much less common than early-stage BCC, it is important to work with a healthcare team with members who have experience treating advanced BCC.

Here, we look at some questions to help people with advanced BCC talk to their healthcare teams, better understand their diagnosis, and better understand their treatment options.

What is advanced BCC?

When used to describe basal cell carcinoma, the word “advanced” refers to cancers that have metastasized (meaning they have spread to distant areas of the body) as well as cancers that are considered “locally advanced.”

“Locally advanced” usually refers to cancers that are larger, more aggressive, more invasive, or have recurred after treatment. However, there is no official definition of “locally advanced” and categorizing BCC as locally advanced is something that will be determined by a healthcare team.

One way of defining locally advanced is whether or not surgery and/or radiation on their own are appropriate treatment options—for example, if a tumor is too large or in a location where surgery would be disfiguring or cause too much damage to healthy tissue.

Questions to ask to better understand your diagnosis:

• What is the size of the primary tumor?
• How deep is the primary tumor? Have any surrounding tissues (such as bone, cartilage, nerves, or muscle) been damaged or affected?
• Has the cancer spread to other areas of the body?
• Do I need any tests to tell us more about the cancer?
• Do I need to see any specialists?

Your healthcare team also needs to know about your medical history, including if you have previously had skin cancer, another type of cancer, and any cancer treatments that you have received in the past.

Questions about treatment options

Treatment for advanced BCC may involve a combination of different therapies. Surgery and radiation may be used in some cases but may not be effective or possible in other cases. Targeted therapy, chemotherapy, and/or immunotherapy are also used in the treatment of advanced BCC.

Questions to ask to better understand a particular treatment option:

• What is the goal of this treatment?
• How does this treatment work?
• How is this treatment given?
• How will we know if this treatment is working?
• How much does this treatment cost?
• How long will I be taking this treatment?
• What are the potential side effects?
• What will my life be like during treatment?
• What kind of follow-up care will I need after treatment?

Remember, there is no best treatment for advanced BCC, only the treatment approach that is best for a particular person at a particular time. Because your diagnosis of BCC is unique, your best source of information is your healthcare team.