What is Bowen's disease?
This page tells you about a type of skin cancer called Bowen's disease. There is information on
Bowen's disease is the name for a pre-invasive form of squamous cell skin cancer. It is also called squamous cell carcinoma in situ. Pre-invasive means that cancer cells are present. But they are only in the outermost layer of skin, the epidermis. This means that the cancer cells will not spread to the lymph nodes. But it does often spread along the skin surface. If left untreated, the Bowen's disease can spread into the deeper layers of the skin (invasive cancer) and may 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 as long as the Bowen's has not been treated.
Like squamous cell carcinoma 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.
In many cases of Bowen's disease, we do not know the cause. 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. A particular type of Bowen's called bowenoid papulosis 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.
Usually Bowen's appears as reddened patches. Sometimes these are raised spots, or they may look like warts. Often the affected skin looks as if it is windblown - looking red and sore. Bowenoid papulosis, which usually occurs on the pubic or genital area in men and women, appears as brown or dark brown patches. When Bowen's is found in the vulval area (between a woman's legs) 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.
There are many effective treatments such as
- Imiquimod cream
- Chemotherapy creams, put straight onto affected skin
- Freezing with liquid nitrogen
- Surgery
Because there are so 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 get rid of completely.
There is a section on non-melanoma skin cancer in CancerHelp UK.
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