What to know about lip cancer

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Lip cancer is a type of oral cancer that begins in the mucosa of the mouth. This is the tissue that lines the mouth.

Lip cancer is the most common cancer of the mouth.

More than 90% of oral mucosa cancers, including lip cancers, begin in the squamous cells of the epidermis. Squamous cells are thin, flat cells that line the lips and other areas of the mouth. These cells grow out of control and form lesions or tumors on the lips.

Early diagnosis is key to treating the cancer and preventing it from spreading to other parts of the body.

Anyone can get lip cancer. However, certain lifestyle and environmental factors can increase a person’s risk of developing this disease.

These factors include:

• heavy alcohol use
• smoking or using tobacco products
• prolonged exposure to natural or artificial sunlight, such as from tanning beds

Other risk factors for lip cancer include:

• being male
• having light-colored skin
• being over the age of 40 years
• contracting certain strains of the human papillomavirus (HPV), including strains 16 and 18

The most common symptom of lip cancer is a sore on the lips or inside the mouth that does not heal. People who have mouth sores that do not heal within 2 weeks or that partially heal and then come back should see a doctor.

Other signs and symptoms of lip cancer can include:

• a lump on the lips or a noticeable thickening
• painful or numb lips
• bleeding from the lips
• a red or white patch on the lips
• tightness in the jaw that results from swelling

As with other types of cancer, lip cancer may not always have obvious symptoms in the early stages. People sometimes discover that they have lip cancer during a routine visit to their dentist.

The symptoms of lip cancer can be similar to those of other conditions, so it is important to see a doctor or dentist about any unexplained lesions or bleeding from the lips. Even if the person does not have cancer, they may need treatment for an injury or infection.

The early signs of lip cancer may be subtle. As the cancer grows and spreads, it may resemble a large wound or injury. Some things to look for include:

• any growth on the lips, especially if it is discolored
• a wound on the lips, especially if it appears for no reason
• bleeding or crusty spots on the lips
• wounds that change the shape or size of the lips
• unexplained swelling on the lips, tongue, or mouth

A growth on the lips does not have to look like these pictures to be cancerous.

Lip cancer accounts for just 0.6% of new cancer cases in the U.S., while cancers of the oral cavity and pharynx account for 3%.

According to the National Cancer Institute (NCI), rates of lip cancer declined in the 30 years between 1992 and 2019 from 1.5 cases per 100,000 persons to 0.6 cases per 100,000 persons. The rate of decline slowed between 2008 and 2019, remaining roughly the same.

Based on data from 2017-2019, the NCI predicts that about 0.1% of men and women will receive a diagnosis of lip cancer at some point in their life.

A person should consult a doctor or dentist about any unusual changes to their lips or mouth, particularly lumps or other lesions that do not get better on their own.

Regular visits to the dentist increase the likelihood of detecting lip and other types of oral cancer early. It is especially important for people with a higher risk of developing lip cancer to have regular dental checkups.

If a dentist suspects or discovers lip cancer, the person needs to book an appointment with a healthcare professional. A doctor can fully diagnose lip cancer and work with the person to develop an appropriate treatment plan.

A doctor typically begins a diagnosis by reviewing a person’s symptoms, medical history, and risk factors. They may ask about:

• the family history of cancer and other diseases
• tobacco or alcohol consumption
• previous or current medical conditions
• history of dental procedures

The doctor will then carry out a physical examination of the person’s mouth. Typically, they will closely inspect the lips and the inside of the mouth for lumps and abnormalities. The doctor may also check the lymph nodes in the neck for swelling.

If the doctor suspects that a person has lip cancer, they will usually perform a biopsy. This test involves taking a small sample of skin from the affected area and examining it under a microscope for signs of cancer.

If the biopsy confirms a diagnosis of lip cancer, the doctor will order additional tests to help determine the stage of the cancer and if it has spread to other areas of the body. These tests may include imaging tests and an endoscopy, or the doctor may take more tissue samples.

Overall, lip cancer survival rates are good— 91% at 5 years, according to the American Cancer Society (ACS). This means that lip cancer is not a particularly aggressive cancer. Because it is in a visible location on the body, a person might notice it earlier than some other cancers.

Cancers that test positive for HPV have a higher survival rate. However, research cautions that statistics often group many different types of oral cancers together, so it is not clear whether HPV really improves survival or how it correlates with survival.

The type of treatment for lip cancer typically depends on:

• the stage of the cancer
• the size and location of the tumor
• the person’s general health

A doctor will discuss the available treatment options with the person and work closely with them to develop a suitable treatment plan.

Standard therapy for lip cancer usually involves a combination of surgery and radiation therapy. Surgeons aim to remove the tumor and restore the function and appearance of the lips. Radiation therapy involves the use of high-energy beams to kill tumor cells and prevent cancer from returning.

Removing the cancer increases the chances of fully curing it.

Other treatment options for lip cancer can include:

• cryotherapy
• targeted therapy drugs
• chemotherapy

It is not always possible to prevent lip cancer. However, a person can reduce their risk of developing lip cancer by:

• using appropriate sun protection when outside, including sunscreen, lip balm with SPF protection, and a hat with a brim
• limiting or avoiding the use of tanning beds
• reducing alcohol intake
• quitting tobacco products and avoiding tobacco smoke
• having regular dental checkups

The outlook for people with lip cancer is generally good if a doctor detects and treats the disease early.

The ACS reports an overall 5-year survival rate of 91%. If the cancer spreads nearby, 5-year survival drops to 65%. If the cancer spreads even more and to distant areas of the body, survival rates at 5 years are 33%.

Lip cancer can recur even after a doctor removes it and the cancer is gone. If recurrence happens quickly, the prognosis is often worse.

Early signs of lip cancer often include a lump or sore on the lips or inside the mouth that fails to heal. Lip cancer is most common in older males with light-colored skin, though it can happen to anyone. A person should not ignore any sore on the mouth.

The treatment options for people with lip cancer depend on the stage and size of the tumor. However, standard therapy usually involves a combination of surgery and radiation therapy. Early detection and treatment of lip cancer significantly improve a person’s outlook.

People can reduce their risk of lip cancer by using sun protection, limiting alcohol intake, and avoiding the use of tobacco products. Having regular dental checkups makes the early detection of lip cancer more likely.