Once diagnosed with basal cell carcinoma (BCC), patients should be involved in vigilant monitoring and proactive treatment. While early-stage BCC can often be treated successfully, advanced or metastatic BCC requires more comprehensive care.1
After a BCC diagnosis, regular in-office screenings become essential. Patients are advised to have these screenings at least once yearly to detect any new primary skin cancers, including BCC, cSCC, and melanoma. Cohort studies and registries have shown that individuals with one BCC are at a higher risk of developing additional skin cancers.1 Indeed, in a prospective cohort study, Wehner et al. discovered that the likelihood of developing another non-melanoma skin cancer (NMSC) within 5 years after being diagnosed with the first one was 40.7%. The likelihood increased to 59.6% at 10 years. Additionally, after being diagnosed with more than one NMSC, the probability of developing another NMSC increased to 82% after 5 years and 91.2% after 10 years.2
It’s important for patients who have had BCC to be informed about the risk of developing new primary skin cancers. They should be advised about the importance of in-office screening and the potential benefits of self-screening. Patient self-surveillance for BCC and other skin cancers can be valuable in identifying new tumors at an early stage when they are easier to treat. Additionally, family members can assist in the detection of skin cancers, particularly in areas of the body that are difficult for the patient to observe, such as the back.1
Patients should be guided on sun safety measures to reduce their risk of further skin damage. Clinicians should recommend using broad-spectrum sunscreens, seeking shade, wearing protective clothing, and avoiding tanning booths.1
Advanced BCC can lead to significant local tissue destruction and disfigurement, impacting a patient’s quality of life. Symptoms like red lesions, itching, and cancer-related stress are common. A study of 21 patients with advanced BCC highlighted the prevalence of these symptoms and their impact on daily activities and emotional well-being (Table).3
To help manage the psychological impact of advanced BCC, patients can benefit from supportive care, including4:
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