Lip cancers are growths of abnormal cells that develop on the lips. They are the most common type of oral cancers. These are cancers that develop in thin, flat cells—called squamous cells—that line the mouth, tongue, cheeks, sinuses, lips, throat, and hard and soft palates. Lip cancers and other kinds of oral cancers are types of head and neck cancers.
Certain lifestyle choices, such as smoking, drinking, and tanning, increase your risk of developing lip cancers. Dentists are the first line of defense against lip cancers, as they are typically the first to notice signs of lip cancers, often during a routine dental exam.
Lip cancers are highly curable when diagnosed early.
The primary cause of lip cancers is the use of tobacco products. When tobacco is chewed or inhaled by smoking, the mucous membranes of the mouth can become irritated.
The second most common cause of lip cancers is excessive intake of alcohol.
Sun exposure is also a major risk factor, especially for people who work outdoors.
Your behaviors and lifestyle heavily influence your risk for lip cancers. According to the National Institutes of Health (NIH), about 40,000 people are diagnosed with oral cancer each year (NIH). Factors that may increase your risk for lip cancers include:
- smoking or using tobacco products (cigarettes, cigars, pipes, or chewing tobacco)
- heavy use of alcohol
- exposure to direct sunlight (both natural and artificial), including the use of tanning beds, over long periods of time
- having a fair complexion or light-colored skin
- being male
- infection with human papillomavirus (HPV), a sexually transmitted virus
- being older than 40 years of age
The majority of oral cancers are linked to tobacco use. The risk is even higher for people who both use tobacco and drink alcohol, compared with those who use only one of the two.
Signs and symptoms of lip cancers include the following:
- a sore, lesion, blister, ulcer, or lump on the mouth that does not go away
- a red or white patch on the lip
- bleeding or pain on the lips
- swelling of the jaw
Lip cancers may not have any symptoms and are sometimes first noticed by a dentist during a regular dental exam.
If you believe you have a sore or lump on your lips, it does not necessarily mean you have lip cancer. Discuss your symptoms with your doctor.
If you experience any of the symptoms for lip cancers, you should see your doctor. He or she will conduct a physical examination of the lips and other parts of the mouth to search for abnormal areas.
The doctor will use a gloved finger to feel inside the lips and use mirrors and lights to examine the inside of the mouth. He or she may also feel your neck for swollen lymph nodes. Your doctor will also ask you about your health history, past illnesses, medical and dental treatments, family history of disease, and any medications you are taking.
If lip cancer is suspected, a biopsy can confirm the diagnosis. The doctor will take a small sample of the abnormal area and review it in a laboratory under a microscope. If your doctor confirms that you have lip cancer, he or she may then perform a number of other tests in order to determine how far the cancer has progressed and/or if it has spread to other parts of the body.
Tests may include:
- computed tomography (CT) scan
- positron emission tomography (PET) scan
- chest X-ray
- complete blood count (CBC)
- endoscopy (a thin instrument inserted through an incision that allows a physician to view inside the body)
Lip cancers can be treated through one or more of the following: surgery, radiation therapy, and chemotherapy. Other possible options include investigative treatments such as immunotherapy and gene therapy.
As with other cancers, treatment depends on the stage of the cancer (how far it has progressed), the size of the tumor, and the patient’s general health.
- If the tumor is small, surgery is typically used to remove it. This involves removal of all tissue involved with the cancer, plus reconstruction of the lip (cosmetically and functionally).
- If the tumor is larger or at a later stage, radiation and chemotherapy may be used to shrink the tumor prior to surgery. Chemotherapy treatments deliver drugs throughout the body and reduce the risk of the cancer spreading or returning.
- For patients who smoke, quitting smoking before radiation treatment can improve treatment outcomes.
Left untreated, a lip tumor can spread to other areas of the mouth and tongue. If the cancer spreads, it becomes much more difficult to treat.
Additionally, treatment for lip cancers can have many negative consequences. Patients who receive surgery to remove large tumors on their lips may experience trouble with speech, chewing, and swallowing after the surgery. They may need to work with a speech pathologist to improve speech, and reconstructive or cosmetic surgeons to rebuild the bones and tissues of the face.
Some side effects of chemotherapy and radiation include:
- hair loss
- weakness and fatigue
- poor appetite
- numbness in the hands and feet
- severe anemia
- weight loss
- dry skin
- sore throat
- change in taste
- inflamed mucous membranes in the mouth (oral mucositis)
Fortunately, lip cancers are very curable. This is because the lips are prominent and visible, and lesions can be seen and felt easily. This allows for early diagnosis. The chance of survival, without recurrence, after treatment, is greater than 90 percent (University of Texas).
Patients who have had lip cancers in the past have an increased chance of developing a second cancer in the head, neck, or mouth. After finishing treatment for lip cancer, you should see your doctor for frequent checkups and follow-up visits.
Lip cancers can be prevented by avoiding the use of all types of tobacco, avoiding excessive alcohol intake, and limiting exposure to both natural and artificial sunlight, particularly the use of tanning beds.
Since many lip cancers are first discovered by dentists, it is important to make regular dental appointments with a licensed professional, especially if you are at an increased risk for lip cancers.