Menu

What Is Advanced Basal Cell Carcinoma?

Medically Reviewed by Brunilda Nazario, MD on January 25, 2021

Advanced basal cell carcinoma is a more complex type of basal cell carcinoma (BCC) -- the most common kind of skin cancer. You usually get it from lots of unprotected sun exposure. But environmental and lifestyle factors, certain medication, and your genes can play a role.

A doctor can help you find the best treatment. You might need radiation, surgery, or special drugs. But you’ll need to get care right away. That’s because this kind of skin cancer can damage your tissue or bones. And it can be life-threatening if left untreated.

What Makes It Advanced?

Experts don’t agree on one definition. But it’s generally considered BCC that’s hard to treat with standard therapy.

Problems come up for a number of reasons. For example, your tumor might be more aggressive. That means it grows faster and is deeper than typical BCC. Or maybe surgery isn’t possible because the tumor is too close to a vital organ, like your brain.

Other factors that lead to a diagnosis of advanced BCC include:

  • Your tumor covers a big area
  • Edges of your tumor aren’t well-defined
  • Radiation therapy isn’t possible
  • Your previous treatment didn’t work
  • Your cancer grows fast or comes back

There are two categories:

Locally advanced BCC. This is when the cancer spreads to tissue around your original tumor. It’s what happens most of the time with advanced BCC.

Metastatic BCC. Very rarely, BCC can spread to different parts of your body. That means cells from your original tumor show up somewhere else. Your doctor is most likely to find metastatic BCC in your bones, lungs, liver, or lymph nodes. This is the most serious kind of advanced BCC.

How Is It Different From Other Skin Cancer?

Advanced BCC starts in your basal cells, which are in the top layer of your skin. It also tends to grow a lot slower than melanoma. That’s the deadliest kind of skin cancer. It starts in cells called melanocytes.

Where Can You Get It?

Any kind of skin cancer is more likely to show up on areas exposed to the sun. Most of the time, advanced BCC affects you from the neck up. But it’s possible to get it other places, like your genitals.

Advanced BCC more commonly affects these areas:  

  • Eye or eyelid
  • Brain
  • Ear canal
  • Nose
  • Lips
  • Bones in your face or skull

It sometimes leads to complications such as:

  • Unwanted cosmetic changes
  • Trouble hearing or seeing
  • Nerve problems in your head or neck
  • Central nervous system issues

Who Gets It?

It’s hard to predict who’ll get advanced BCC. Some things that raise your chances include:

  • A history of skin cancer
  • Certain genetic disorders  
  • Not getting early medical care
  • Taking long-term medicine to slow down your immune system

How Do You Treat It?

Your health care team will come up with a plan based on your specific case.

You may need:

  • Surgery
  • Radiation
  • Chemotherapy
  • Targeted therapy

There’s ongoing research into what works best for advanced BCC. Your doctor might suggest joining a clinical trial if other treatments aren’t successful. That’s a study that looks at new kinds of drugs or treatment methods.    

When to See Your Doctor

Skin cancer is more likely to show up in certain people, like those with fair skin. But anyone can get it. You should check with your regular doctor or a dermatologist whenever you see certain changes in your skin.

Here are some signs to watch for:

  • A sore that won’t heal
  • A shiny bump
  • A new brown spot (in people with darker skin)
  • A bump with a dent or rolled edges
  • A growth that itches, bleeds, leaks pus, or gets crusty
WebMD Medical Reference

Sources

SOURCES:

Current Dermatology Reports: “Advanced Basal Cell Carcinoma: Epidemiology and Therapeutic Innovations.”

Frontiers in Oncology: “Sonidegib for the Treatment of Advanced Basal Cell Carcinoma.”

McDaniel, B., Badri, T., Steele, R.B. Basal Cell Carcinoma. StatPearls, 2020.

Clinical & Translational Oncology: “Management of high-risk and advanced basal cell carcinoma.”

Dermatology and Therapy: “Sonidegib: Safety and Efficacy in Treatment of Advanced Basal Cell Carcinoma.”

Cancer Support Community: “Advanced Basal Cell Carcinoma – What You Need to Know.”

Anti-Tumour Treatment: “Emerging trends in the treatment of advanced basal cell carcinoma.”

American Academy of Dermatology: “Skin Cancer Types: Basal Cell Carcinoma Signs and Symptoms.”

Skin Cancer Foundation: “Melanoma,” “Basal Cell Carcinoma.” 

© 2021 WebMD, LLC. All rights reserved.