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Living with cancer· Appointment prep

Appointment sheet: Basal cell carcinoma

One page to bring and write on: your details, the questions for Basal cell carcinoma plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Basal cell carcinoma

Prepared with OnCo (onco.cc/prep/basal-cell-carcinoma/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

14 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Histologic subtype and high-risk location, PTCH1 / SMO / SUFU alterations, Perineural invasion, Germline PTCH1), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Low-risk
  1. 5.For my situation (low-risk), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Fluorouracil (5-FU), and what side effects should I expect?
High-risk or recurrent
  1. 7.For my situation (high-risk or recurrent), which of the standard options do you recommend and why?
Locally advanced or metastatic
  1. 8.For my situation (locally advanced or metastatic), which of the standard options do you recommend and why?
  2. 9.Am I a candidate for Vismodegib, Sonidegib, Cemiplimab, and what side effects should I expect?
Any stage
  1. 10.Are there clinical trials I could join, for example of Cemiplimab, Vismodegib?
  2. 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 13.I read that “Hedgehog-inhibitor tolerability leads most patients to stop within a year”. How does that affect my plan?
  5. 14.I read that “Resistance via SMO mutations has no approved next-in-class agent”. How does that affect my plan?

The words I may hear

  • Cancer stem cell theory and phenotypic plasticity: The idea that a tumour is organised like a tissue, with a small pool of stem-like cells that renew it and a bulk that cannot, so killing the bulk shrinks the tumour but the stem-like cells regrow it.
  • Immune-related adverse events (irAEs): Immune-related adverse events (irAEs) are the autoimmune side effects of checkpoint inhibitors: colitis, thyroid problems, rash, hepatitis, pneumonitis.

Tests and results to bring

Biomarker results to ask for: Histologic subtype and high-risk location (H-zone of face), PTCH1 / SMO / SUFU alterations (research; SMO mutations predict hedgehog-inhibitor resistance), Perineural invasion, Germline PTCH1 (Gorlin).

Scans and tests linked to this cancer: Confocal microscopy and optical coherence tomography for skin (VivaScope, VivoSight, deepLive), Dermoscopy, total-body photography & AI skin analysis, Skin cancer screening (visual skin examination).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

  • High-risk or recurrent: Mohs micrographic surgery or excision with complete margin assessment; radiotherapy if surgery not feasible. (IMRT / IGRT (modern external beam))
  • Locally advanced or metastatic: Vismodegib or sonidegib; cemiplimab after hedgehog-inhibitor failure or intolerance; multidisciplinary review for surgery/radiotherapy after response. (Vismodegib, Sonidegib, Cemiplimab)
  • Low-risk: Standard excision with 4 mm margin, curettage and electrodesiccation, or topical imiquimod / 5-FU / photodynamic therapy for superficial lesions. (Fluorouracil (5-FU))

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call