Living with BCC
Patients with basal cell carcinoma (BCC) may experience a reduced quality of life due to various factors such as physical and functional deficits, and psychosocial issues related to potential disfigurement.1 While BCC is usually not life-threatening, it affects the skin, the body’s largest and most visible organ. Distress can profoundly impact one’s self-image and interactions with others.2
The face, head, and neck are the most commonly affected areas, which can significantly influence a person’s body image, self-esteem, and overall quality of life. The cosmetic outcomes of treatment in these areas are crucial, as they can affect a patient’s confidence and mental well-being. Distress and body image issues can arise both from the presence of the tumor and the effects of its treatment.2
Treatment and Its Impact
Surgery
Surgery for BCC can have both short- and long-term risks. Immediate post-surgery issues may include bleeding and medication reactions. Long-term effects may include3:
Nerve Damage
Surgery can cause sensory nerve damage, leading to numbness, tingling, or pain. Motor nerve damage can result in weakness or paralysis. Nerve damage may improve within 12 months, but sometimes symptoms persist.
Wound Complications
Wound infections, delayed healing, or breakdown can occur. Keep follow-up appointments and report any issues to your surgery team.
Lymphedema
This swelling is caused by damage to lymph nodes or channels and can occur after extensive surgery. A lymphedema therapist can help with treatments like skin care, massage, and compression garments.
Cosmetic outcomes, such as scarring or changes in skin color, can also be a concern, especially with advanced BCC. An effective reconstruction plan and emotional support are crucial.3
Radiation Therapy
Radiation side effects are typically localized to the treated area and may include3:
- Skin irritation, ranging from redness to blistering and peeling
- Changes in skin color
- Hair loss in the treated area
- Increased risk of new skin cancers in the radiated area
- Damage to salivary glands and teeth (for cancers near the mouth)
- Fatigue, taste changes, difficulty swallowing, and thyroid issues (for head and neck radiation)
Targeted Therapy
Abnormal signaling in the Hedgehog pathway is a principal driver in BCC’s progression and pathogenesis. Vismodegib and sonidegib are agents known as Hedgehog pathway inhibitors. They are FDA-approved for the treatment of advanced BCC. These therapies are often associated with side effects that may include4:
Immunotherapy
Immune checkpoint inhibitors are agents that boost the immune system to help it fight cancer. One such agent–cemiplimab (Libtayo®)-is FDA-approved to treat advanced BCC, and others, such as pembrolizumab (Keytruda®) and nivolumab (Opdivo®), have been and continue to be studied as potential treatment options. Common side effects include: fatigue/weakness, rash or other skin issues, diarrhea, nausea, vomiting, constipation, cough, and muscle/joint pain.
As immunotherapies, these agents may cause the immune system to attack healthy tissues, resulting in effects on various body systems, including3:
- Lungs, liver, skin, and nervous system
- Heart and eye health
- Gastrointestinal tract and hormonal glands
Maintaining Health During and After Treatment
You can do several things to stay healthy during and after skin cancer treatment5:
Coping with Feelings
Having cancer can evoke feelings of fear, sadness, or anxiety. Here are ways to cope5:
Talk About Your Feelings
Share your emotions with someone you trust.
Seek Support
Consider friends, family, religious leaders, or support groups for help.
Stay Active
Engage in enjoyable activities and maintain healthy habits.
Professional Help
If you feel down for more than a few days, seek professional counseling.
Getting Help
Don’t hesitate to ask for help with daily tasks like cooking and cleaning. Support groups and one-on-one counseling can be beneficial. Communicate with your healthcare provider about your feelings; they can guide you to the appropriate support resources.5
References
- Rhee JS, Matthews BA, Neuburg M, Logan BR, Burzynski M, Nattinger AB. Validation of a quality-of-life instrument for patients with nonmelanoma skin cancer. Arch Facial Plast Surg. 2006;8:314-318. doi:10.1001/archfaci.8.5.314
- Stundys D, Ulianskaite G, Stundiene I, Grigaitiene J, Jancoriene L. The quality of life in surgically treated head and neck basal cell carcinoma patients: A comprehensive review. Cancers (Basel). 2023;15:801. doi:10.3390/cancers15030801
- Skin Cancer Care. Living With Basal Cell Carcinoma: Dealing With The Side Effects Of Treatment. (https://skincancerinfo.org/living-with-bcc-dealing-with-side-effects/).
- Bakshi A, Chaudhary SC, Rana M, Elmets CA, Athar M. Basal cell carcinoma pathogenesis and therapy involving hedgehog signaling and beyond. Mol Carcinog. 2017;56:2543-2557. doi:10.1002/mc.22690
- American Cancer Society. Living With Skin Cancer. 2021. (https://www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets-flyers/living-with-skin-cancer.pdf).
All URLs accessed April 3, 2026
