What Are Signs of Cancer on the Lip?

Lip cancer has an overall five-year survival rate of 92 percent.

Lip cancer is a type of oral (head and neck) cancer that can occur anywhere along the upper or lower lip, but it most commonly affects the lower lip.

Most lip cancers are squamous cell carcinomas. Changes (mutations) occur in the DNA of squamous cells (thin, flat cells in the middle and outer layers of the skin). Abnormal cells start multiplying uncontrollably and form a tumor that can invade and destroy normal body tissue.

Lip cancer accounts for approximately 0.6 percent of all cancers in the United States.

The most commonly seen signs of early lip cancer include:

• A flat or slightly raised whitish discoloration of the lips
• A sore or a blister on the lip that does not heal and tingling
• Pain or numbness of the lips or the skin around the mouth
• Bleeding in the lip or mouth
• Swelling of the jaw
• Areas of leukoplakia (white patches)

The exact cause of lip cancer is not yet known.

Certain risk factors may predispose a person to develop the disease, such as:

• Excessive sun exposure (ultraviolet light)
• Having light-colored skin
• Age older than 40 years
• Male gender
• Excessive alcohol consumption
• Tobacco uses in any form, such as cigarettes, cigars, pipes, chewing tobacco, and snuffs
• A weakened immune system due to HIV infection, AIDS, and an organ transplant
• Human papillomavirus virus infection (strains 16 and 18)

The stages of lip cancer include the following:

1. Stage 0 (carcinoma in situ)
   • Cancer is confined to the lining of the lips and oral cavity.
2. Stage I
   • The tumor is 2 cm or smaller, and the deepest point of tumor invasion is smaller than 5 mm.
3. Stage II
   • The tumor is either:
     • Smaller than 2 cm and the deepest point of tumor invasion is greater than 5 mm.
     • Larger than 2 cm and smaller than 4 cm and the deepest point of tumor invasion is smaller than 10 mm.
4. Stage III
   • The tumor is either:
     • Between 2 to 4 cm and the deepest point of tumor invasion is greater than 10 mm.
     • Larger than 4 cm and the deepest point of tumor invasion is smaller than 10 mm.
     • Has spread to at least one lymph node (smaller than 3 cm) on the same side of the neck as the primary tumor.
5. Stage IV
   • Stage IVA: The tumor is larger than 4 cm and the deepest point of tumor invasion is greater than 10 mm or cancer has spread to the outer surface of the upper or lower jawbone, into the maxillary sinus, or to the skin of the face.
     • Any size, but cancer has spread to either:
       • One lymph node (less than 3 cm) on the same side of the neck is the primary tumor, and cancer has spread through the outside covering of the lymph node into nearby connective tissue.
       • One lymph node (3 to 6 cm) on the same side of the neck is the primary tumor.
       • Multiple lymph nodes (less than 6 cm) are on the same neck side as the primary tumor.
       • Multiple lymph nodes (less than 6 cm) on the opposite side of the neck as the primary tumor or both sides of the neck.
   • Stage IVB:
     • The tumor has either spread to:
       • One lymph node (bigger than 6 cm).
       • One lymph node (larger than 3 cm) on the same side of the neck is the primary tumor, and cancer has spread through the outside covering of the lymph node into nearby connective tissue.
       • One lymph node (any size) on the opposite side of the neck, and cancer has spread through the outside covering of the lymph node into nearby connective tissues.
       • Multiple lymph nodes and cancer has spread through the outside covering of any lymph node into nearby connective tissue.
       • The muscles or bones required to chew, the sphenoid bone behind the upper jaw, and/or the carotid artery near the base of the skull
   • Stage IVC: Cancer has spread beyond the lip or oral cavity to distant parts of the body, such as the lung, liver, or bones.

The doctor may recommend certain tests and procedures to confirm the diagnosis of lip cancer.

• Physical examination: The doctor will examine the lips, mouth, face, and neck to look for signs of cancer.
• Imaging tests: To determine whether cancer has spread beyond the lip.
  • CT scan
  • MRI scan
  • Positron emission tomography scan
• Biopsy: Removing and analyzing a sample of tissue to determine whether cancer is present, the type of cancer, and the level of aggressiveness.

Treatment for lip cancer usually involves the following:

• Surgery: To remove the cancerous tissue and a margin of healthy tissue surrounding it.
  • For small lip cancers: Mohs’ surgery repairs the lip post-surgery.
  • For larger lip cancers: Skilled plastic and reconstructive surgeons are needed to repair the lip.
• Radiation therapy: Powerful energy beams (X-rays or protons) destroy cancer cells.
• Chemotherapy: Potent drugs eliminate cancer cells.
• Targeted drug therapy: Drugs focus on specific weaknesses present within the cancer cells.
• Immunotherapy: A drug treatment that encourages the immune system of the body to fight cancer.

Lip cancer has an overall five-year survival rate of 92 percent because this type of cancer is detected and treated early in most cases.

The prognosis of lip cancer depends on the following:

• The stage of cancer when diagnosed
• Location and size of the tumor
• The extent of the spread of cancer to blood vessels
• Age of the person
• The overall health of the person

Though lip cancer cannot be prevented completely, the following measures could help reduce your risk:

• Stop using tobacco in any form
• Avoid heavy alcohol use
• Practice healthy eating habits and a good lifestyle
• Use medications to treat a precancerous condition or prevent cancer from developing
• Avoid direct sunlight exposure
• Protect the face from the sun with a wide-brimmed hat or sunblock
• Apply a broad-spectrum sunscreen with a sun protection factor of at least 30 throughout the year
• Avoid tanning beds