Active surveillance for basal cell carcinoma: experiences of patients and proxies

Basal cell carcinoma (BCC) is characterized by slow growth and a low malignant potential. Recently, active surveillance (AS) has gained attention as an alternative management option for BCC patients. This study aimed to explore the experiences of patients and their proxies with AS.

An interview study was conducted involving 15 patients who previously chose AS for one or more BCC and 12 accompanying proxies. Patients from two hospitals (Radboud University Medical Center, Nijmegen, the Netherlands, and University Hospital Ghent, Belgium) were included.

Five themes emerged: reasons for choosing AS, experiences during AS, reasons for continuation or discontinuation, needs and barriers, and proxies' experiences. Overall, the experience with AS was positive, with minimal impact on daily life. Negative experiences included the follow-up burden and BCC symptoms. Patient's needs included clear communication about the nature of BCC and proactive discussion of AS by the healthcare provider. Impact on the proxies was limited, but they played a valuable supportive role in decision-making and follow-up.

The experiences of patients and proxies indicate that AS is a valuable option for BCC, particularly for older patients and/or patients experiencing cumulative treatment burden. The need for dermatologists to proactively discuss AS was highlighted.