How To Detect And Treat Lip Cancer Effectively

What Is Lip Cancer?

Lip cancer most often begins in the squamous cells of the lower lip, but can also occur on the upper lip. It may appear as a persistent sore, scaly patch, lump, or ulcer on the lip that doesn't heal. The lower lip is more vulnerable since it receives more sun exposure.

Lip cancer is a type of oral cavity cancer. When lip cancer symptoms are detected early, it is highly treatable. However, without timely treatment, the cancer can spread to nearby lymph nodes and other parts of the body.

How Common is Lip Cancer?

Lip cancer is relatively uncommon, accounting for a small percentage of all oral cavity cancers. According to recent estimates, the Indian subcontinent reported 0.46 million prevalent cases of lip cancer, accounting for 30% of global cases.

Symptoms

Lip cancer symptoms can be subtle at first. Schedule an exam if you notice any of the following warning signs persisting for over 2 weeks:

• A sore, ulcer, crust, or scaly patch on the lip, often on the lower lip, that doesn't heal.
• A lump, thickening, or wart-like growth on the lip
• Red or white discoloured patches (called erythroplakia or leukoplakia) on the lip surface
• Bleeding, pain, tenderness, or numbness in the lip
• Changes in the shape or size of the lip, persistent swelling, or difficulty opening the mouth fully
• Enlarged lymph nodes in the neck, which can occur if the cancer spreads

Remember, having one of these symptoms doesn't necessarily mean you have lip cancer. However, it's best to get any unusual changes checked promptly to be safe and rule out potential issues.

Causes

Most lip cancers develop due to chronic damage to the DNA of lip cells, often from repeated sun/UV exposure and tobacco use. This damage can cause cells to grow uncontrollably and become cancerous over time. Other factors, such as heavy alcohol use, chronic lip irritation (like ill-fitting dentures or repeated trauma), can also increase risk. Additionally, some infections or a weakened immune system might increase lip cancer susceptibility.

Risk Factors

Certain factors can raise the likelihood of developing lip cancer:

• Excessive sun/UV exposure over time, especially without using lip sunscreen; outdoor jobs carry added risk
• Using any form of tobacco, including cigarettes, cigars, pipes, and smokeless tobacco
• Heavy alcohol consumption, particularly combined with tobacco use, multiplies the risk.
• Being older (lip cancer is most often diagnosed in people in their 60s and 70s) and male.
• Having fair skin or signs of sun damage on the lips (actinic cheilitis)
• Immune system suppression, such as from certain medications or conditions
• History of prior cancers of the head and neck area
• Possible on-the-job exposures in some occupations, like farming and construction, that involve prolonged sun exposure

Complications Regarding Lip Cancer Treatment

Treating lip cancer can sometimes impact both form and function. Lip surgery may affect speech, cause issues like drooling, and alter facial symmetry and appearance, but reconstructive techniques and therapy can help restore normal function.

Radiation therapy may cause temporary side effects like mouth sores, dry mouth, taste changes, dental problems, and skin irritation. Long-term, it can lead to stiffness and a risk of bone damage in the jaw. If the lip cancer spreads to nearby lymph nodes or is more advanced, more extensive treatment is needed, which can increase the risks of recurrence and cancer spread.

Working closely with your doctor to manage side effects, rehabilitate, and monitor your health after lip cancer treatment can improve your quality of life and outcomes.

Diagnosis and Tests

If you have a lip abnormality that could be cancer, your doctor will:

• Examine your lips, mouth, face, and neck carefully, looking for suspicious lesions or enlarged lymph nodes. They will ask about your symptoms and risk factors.
• Perform a biopsy, involving the removal of some or all of the concerning lip tissue to examine under a microscope. This is the only definitive way to diagnose lip cancer and determine its type and grade. In some cases, a surface scraping (cytology) may be done first, but a biopsy is the standard.
• Likely order imaging scans to determine the lip cancer stage (extent of disease). This may include:
  • CT or MRI to assess spread to nearby structures like bone
  • PET/CT to evaluate if cancer has spread to lymph nodes or distant sites, for more advanced cases
  • Dental X-rays or a panoramic X-ray to check the jawbones, if needed
• Analyse the biopsy samples to confirm the lip cancer type (like squamous cell carcinoma), aggressiveness, and if lymph nodes are involved. This informs the cancer stage and treatment plan.

Lip cancer staging considers the tumour size, depth of invasion, lymph node status, and any disease spread to personalise your treatment options.

Treatment

Your doctor will recommend an approach based on the lip cancer stage and your overall health. The lip cancer treatment options include:

Surgery

For small, early-stage lip cancers, surgery to remove the tumour along with a margin of healthy tissue is often the first treatment. Reconstructive surgery techniques aim to restore lip function and appearance as much as possible. If lymph nodes are affected, they may also be removed (neck dissection). Rehabilitation, like speech and swallowing therapy, is helpful after more extensive surgeries.

Radiation Therapy

Radiation may be used as the main treatment for some small lip cancers or after surgery to lower the risk of recurrence, particularly if the margins were close or if lymph nodes were involved. External beam radiation therapy is commonly used. Side effects may include mouth sores, dry mouth, taste changes, and dental issues, which can be managed with good oral hygiene and supportive care from your team.

Chemotherapy

Chemotherapy is sometimes combined with radiation (called chemoradiation) for more advanced lip cancers that cannot be fully removed surgically or have high-risk features. It may also help with recurrent or metastatic disease as part of comprehensive care. Common medicines are cisplatin or carboplatin. Anti-nausea medications and other supportive measures help control side effects.

Targeted Drug Therapy

Targeted therapies block certain proteins that help cancer cells grow. Medications like cetuximab (an EGFR inhibitor) may be used with radiation or for advanced lip cancers in some cases, based on the tumour's characteristics. They tend to have different side effects than chemotherapy. The choice of targeted therapy depends on specific factors and the goals of lip cancer treatment.

Immunotherapy

Immunotherapy harnesses the body's own immune defences to fight cancer. Medications known as immune checkpoint inhibitors, such as pembrolizumab or nivolumab, can be used for recurrent or metastatic lip cancers that progress after chemotherapy. However, eligibility is determined by the medical team based on a careful evaluation.

Prevention

While not all lip cancers can be prevented, you can take steps to reduce your risk:

• Protect your lips from the sun. Use lip balm with SPF 30+, reapply often, wear a wide-brimmed hat, and limit your time in strong midday sun.
• Don't use any form of tobacco and avoid secondhand smoke. If you use tobacco, consider quitting.
• Limit alcohol use, and don't combine drinking with smoking, as this raises the risk further.
• See your dentist regularly and check your lips yourself. Have any sore or change that lasts more than 2 weeks promptly examined.
• If you have precancerous lip changes like actinic cheilitis, follow your doctor's recommendations for treatment and monitoring.
• Maintain good oral hygiene, eat a balanced diet, and avoid chronic irritation from things like ill-fitting dentures or chewing tobacco.

At Metropolis Healthcare, we understand the importance of prompt and accurate diagnosis. Our team of skilled pathologists and state-of-the-art diagnostic laboratories is committed to providing reliable results to guide your treatment decisions. With a network of conveniently located centres across India and user-friendly online tools, we make it easier for you to prioritise your health.

FAQs

1. Can you kiss someone with lip cancer?

Lip cancer is not contagious. Kissing cannot spread cancer from one person to another. However, if the lip has an open sore or bleeding from the tumour, it's best to avoid kissing until it heals to prevent infections or irritation.

2. Is lip cancer fatal?

With early detection and appropriate treatment, it is often highly curable, especially when caught at the lip cancer's first stage. The 5-year survival rate for localised lip cancer is around 90%. However, survival rates are lower if the cancer is more advanced or has spread.

3. Does lip cancer spread quickly?

Lip cancer doesn't always spread rapidly, but it can grow into nearby tissues and spread to lymph nodes in the neck if not treated. High-grade or advanced cancers tend to spread faster than early-stage tumours. Routine oral exams help catch lip cancers before they spread.

4. What can I expect if I have lip cancer?

If you're diagnosed with lip cancer, you can expect to have a biopsy to confirm the diagnosis, imaging tests to determine the extent of the disease, and a personalised treatment plan. Lip cancer treatment often involves surgery and/or radiation therapy, along with reconstructive procedures and support like speech therapy as needed.

5. Can lip cancer be cured?

Yes, many lip cancers can be cured, especially when detected and treated early. Even more advanced lip cancers can often be controlled or managed with a combination of surgery, radiation, and systemic therapies.

6. Does lip cancer grow quickly?

The rate of lip cancer growth varies. Some tumours are slow-growing, while others may grow and spread to adjacent tissues more quickly. Factors like the cancer grade and stage influence this. Promptly getting any suspicious lip changes checked allows for timely treatment if needed.