Vismodegib for Advanced Basal Cell Carcinoma: What Patients Need to Know

Real Case: Advanced Basal Cell Carcinoma on the Face with Limited NHS Options

This week I was quoted in the Sunday Express about a patient with advanced basal cell carcinoma affecting his face. Sergei, a 70-year-old man from Birmingham, lost the vision in one eye because of the tumour. It is now putting his remaining vision at risk.

The frustrating part is this. There is a drug called vismodegib that may help shrink this type of cancer. It is licensed in the UK, and I can prescribe it privately. But under current NHS guidance, the treatment is only funded when a patient has multiple tumours, not just one.

Sergei's case shows what can happen when a guideline is followed rigidly, even when the cancer is visibly progressing. His family came to see me after being told there were no further options.

They wanted to know: what else is out there? Could this treatment help? And why is it not available through the NHS?

This page explains what we know about basal cell carcinoma treatment, when vismodegib might be considered, and how I support patients in these situations.

You can read the full article here.

What Is Basal Cell Carcinoma and How Can It Become Advanced?

Basal cell carcinoma, or BCC, is the most common type of skin cancer. It usually appears on sun-exposed areas such as the face, scalp or neck.

Most BCCs grow slowly and can be treated successfully with surgery or radiotherapy. But in some cases, the tumour becomes larger, deeper, or more difficult to remove.

This is sometimes referred to as advanced basal cell carcinoma.

If a basal cell carcinoma on the face is left untreated for several months or years, it may spread into nearby tissue, bone, or even the eye. These cases are rare, but they do happen.

How Vismodegib Works for Basal Cell Carcinoma Treatment

Vismodegib is a targeted cancer treatment used in certain cases of advanced basal cell carcinoma. It is a once-daily capsule that works by blocking a growth signal used by the tumour.

It may be considered when:

• Surgery is not possible

• Radiotherapy has already been tried

• The tumour is continuing to grow or cause harm

Vismodegib can sometimes shrink or slow the tumour. It is not a cure, but it may improve comfort, appearance, or function in the right setting.

NHS Access to Vismodegib for Advanced Basal Cell Carcinoma

At the moment, vismodegib is not routinely funded on the NHS for people with a single tumour, even if it is large or causing serious harm.

This is based on guidance from NICE, which reviews evidence on effectiveness, safety, and cost. Unless there are multiple basal cell carcinomas present, NHS doctors are usually unable to prescribe it.

This is why some people come to see me privately. I can assess whether vismodegib may be appropriate and explain all of the options available, including cost and alternatives.

Private Treatment with Vismodegib: What to Expect

If vismodegib is recommended, it is taken as a daily tablet at home. I provide close follow-up to monitor progress and manage any side effects.

The cost of vismodegib privately is approximately £8,000 per month. Not every case requires long-term use, and I will always discuss this in detail during the consultation. If you are insured, your policy should cover this cost.

I will also explore whether any further NHS options could still be pursued.

Request a Second Opinion for Basal Cell Carcinoma Treatment

If you or someone you care for has been told there is nothing more that can be done for a basal cell carcinoma, I may be able to help.

A second opinion is often helpful when treatment options feel unclear or exhausted. I will give you an honest view of what’s possible, what to consider, and what might come next.