What is Bowen's disease?

This page tells you about a type of skin cancer called Bowen's disease. There is information on

 

What Bowen's disease is

Bowen's disease is  a very early form of squamous cell skin cancer. It is also called squamous cell carcinoma in situ.  Doctors call Bowen's disease pre invasive. That means that there are cancer cells there. But they are only in the outermost layer of skin, the epidermis. Sometimes it can spread along the skin surface.

If left untreated, Bowen's disease can spread into the deeper layers of the skin.  This means it has become an invasive cancer and it can then spread into the lymphatic system. It takes a long time for Bowen's disease to develop into an invasive cancer. But the risk of developing into a cancer remains until Bowen's is treated.

Like squamous cell cancer of the skin, Bowen's disease can grow anywhere. It is most common on the trunk, arms or legs. The phrase Bowen's disease is often used for squamous cell carcinoma in situ around the genitals or anus.

 

Risks and causes of Bowen's disease

In many cases of Bowen's disease, we don't know what has caused it. Occasionally it is related to arsenic exposure. More commonly it is related to the sun. But as it obviously occurs in areas not normally exposed to the sun, this is not the only cause.

One type of Bowen's disease is called bowenoid papulosis.  This is associated with infection with a type of genital wart virus called HPV-16. This is one of the types of virus that is also associated with cervical cancer and cancer of the penis.

 

Symptoms of Bowen's disease

Usually Bowen's appears as reddened patches. Sometimes these are raised spots, or they may look like warts. Often the affected skin looks red and sore.

Bowenoid papulosis usually occurs on the pubic or genital area in men and women. This appears as brown or dark brown patches. When Bowen's is found in the vulval area (the outside parts of a woman's genitals) or in the mouth, there can be white patches on the skin called leukoplakia. 

A common symptom of Bowen's is itching. But often there are no symptoms apart from a patch on the skin. In some cases, the affected skin may become sore and bleed.

 

Treatment for Bowen's disease

There are a few treatments for Bowen's disease, such as

  • Imiquimod cream
  • Chemotherapy creams which are put straight onto affected skin
  • Freezing with liquid nitrogen
  • Surgery

All these treatments can work well.  Because there are many treatments, and because this is a very early type of skin cancer, the cure rates are high. Even invasive squamous cell cancers have a 90% cure rate. As with any cancer, though, if it is left until it has spread to the lymph nodes, it becomes much more difficult to remove completely.

There is a section on non melanoma skin cancer in CancerHelp UK.