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Below, week by week, is what OnCo's record of Locally advanced and metastatic basal cell carcinoma says about the first two months: the order is typical, the timing is yours to ask about. Locally advanced basal cell carcinoma is a skin cancer that has grown so large or deep, usually on the face, that surgery or radiotherapy can no longer remove it without unacceptable damage. Almost all these tumours depend on the hedgehog growth pathway, and the pills vismodegib and sonidegib shrink about four in ten of them; cemiplimab is used when the pills fail or cannot be tolerated. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Vismodegib for several months to shrink large facial tumours before surgery and reduce the defect.
Vismodegib (ERIVANCE) or sonidegib (BOLT); intermittent dosing to limit cramps, hair loss and taste loss; surgery or radiotherapy after response where feasible.
Vismodegib or sonidegib; cemiplimab after progression; platinum chemotherapy has only case-series support.
Radiotherapy for tumours not resectable but still confined; electron beam and superficial radiotherapy for suitable sites; multidisciplinary review of all advanced cases.
Surveillance and surgery, avoidance of radiotherapy, hedgehog inhibitors for multiple advanced tumours, topical patidegib in trials.
Cemiplimab (approved 2021); clinical trials of intratumoural agents and immunotherapy combinations.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.