Systemic Chemotherapy for Advanced Basal Cell Carcinoma

Systemic chemotherapy (chemo) is the use of anti-cancer drugs that travel through the bloodstream to all parts of the body. Unlike topical chemotherapy, which is applied to the skin, systemic chemotherapy is given into a vein (IV) or taken by mouth and can attack cancer cells that have spread to lymph nodes and other organs.

When might chemotherapy be used for basal cell carcinoma?

Basal cell carcinoma (BCC), also known as basal cell skin cancer, very rarely reaches an advanced stage. Even when it does, advanced basal cell cancers are usually first treated with targeted therapy or immunotherapy drugs.

Chemotherapy might be an option if these other treatments aren’t effective or can’t be used for some reason.

Which chemo drugs might be used for basal cell carcinoma?

Because BCC rarely spreads, there is very limited information on which chemo drugs might be most effective. Chemo drugs sometimes used to treat BCC include:

• Carboplatin plus paclitaxel
• Cisplatin plus paclitaxel
• Doxorubicin

How is chemotherapy given?

Chemo drugs for BCC are given into a vein (IV), often as an infusion over a certain period of time. This can be done in a doctor’s office, infusion center, or in a hospital setting.

Chemo is given in cycles, followed by a rest period to give you time to recover from potential side effects. For example, chemo might be given once a week or every 3 weeks, depending on the drugs used. At the end of the cycle, the chemo schedule repeats to start the next cycle.

The length of chemo treatment depends on how well it’s working and what side effects you have. Chemo for advanced disease is often continued for as long as it is helpful.

If you’re getting chemo, ask your cancer care team about your treatment plan and what to expect.

Possible side effects of chemotherapy

Chemo drugs can cause side effects. These depend on the type and dose of drugs given and how long they are used. The side effects of chemo can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation
• Increased risk of infection
• Easy bruising or bleeding
• Fatigue

These side effects usually go away once treatment is finished.

Talk with your cancer care team about what you might expect, and tell them about any side effects or changes you notice while getting chemo so that they can be treated promptly.

Side effects from certain chemo drugs

Some drugs can also have other side effects. For example, peripheral neuropathy (nerve damage) is a possible side effect of cisplatin, carboplatin, and paclitaxel. It can lead to numbness, tingling, or even pain in the hands and feet. The nerve damage caused by cisplatin can also cause hearing loss.

This might improve once treatment is stopped, but it can last a long time for some people. If you’ll be getting any of these drugs, let your team know right away if you develop numbness and tingling sensations or other side effects.