From the Research
There is no specific maximum area of Bowen's disease that can be treated with Efudix (5-fluorouracil), and treatment can be tailored to individual patient needs, with the most recent and highest quality study suggesting that photodynamic therapy may be a more effective treatment option for some patients 1.
Treatment Considerations
When treating Bowen's disease with Efudix, the standard regimen involves applying a thin layer of Efudix cream (5% 5-fluorouracil) to the affected area twice daily for 3-8 weeks, depending on the response.
- Treatment of extensive areas may need to be done in stages to minimize side effects.
- Patients should be monitored for systemic absorption and toxicity, which may include nausea, vomiting, diarrhea, and myelosuppression, though these are rare with topical application.
- The treatment causes local inflammation, erythema, erosion, and crusting, which can be uncomfortable but indicates the medication is working.
Alternative Treatment Options
For very extensive disease, alternative treatments like photodynamic therapy or surgical approaches might be considered, with photodynamic therapy showing better efficacy, less recurrence, and better cosmetic outcomes than cryotherapy and 5-FU in a recent meta-analysis 1.
- Patients should use sun protection during treatment as the medication causes photosensitivity.
- Follow-up is essential to confirm complete clearance of the disease.
Patient Monitoring and Follow-up
Regular monitoring and follow-up are crucial to ensure the treatment is effective and to detect any potential side effects or recurrence, with studies suggesting that early diagnosis and treatment can prevent progression to invasive epidermoid carcinoma and later dissemination 2.