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, there is a small chance that 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.
In many cases of Bowen's disease, we don't know what has caused it. More commonly it is related to the sun. But as it can occur in areas of the body 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.
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.
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
All these treatments can work well. The treatment you have will often depend on which part of your body is affected. Because there are many treatments, and because this is a very early type of skin cancer, the cure rates are high.
We have a section on non melanoma skin cancer, which describes these treatments in more detail.
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