Lip Cancer

What is lip cancer?

Lip cancer occurs when abnormal cells grow out of control, resulting in tumors (solid tissue masses) or lesions (abnormal areas of skin) on your lips. Most lip cancers (about 90%) are squamous cell carcinoma. This type of cancer starts in the cells located in your skin’s outer layer. Less common types are basal cell carcinoma and melanoma.

Lip cancer can develop on either your upper or lower lip, but it’s more likely to start on your lower lip. The most common sign is a sore, blister, ulcer or lump on your bottom lip that won’t go away.

How common is lip cancer?

Lip cancer is the most common type of oral (mouth) cancer, but makes up less than 1% of all cancer diagnoses total in the United States. Only about .1% of people in the U.S. will get diagnosed with lip cancer at some point in their lives.

What are the symptoms of lip cancer?

Early-stage lip cancer often looks like a mouth sore that won’t heal. It’s easy to mistake tumors for cold sores when they first appear. The difference is that cold sores go away on their own in about 10 days. But lip cancer lesions linger.

Other signs of lip cancer include:

• A flat or slightly raised colored spot on your lips (may appear white or reddish on light skin or dark brown or gray on dark skin).
• Pain, numbness or tingling on your lips or in your mouth.
• Loose teeth. (If you wear dentures, you may notice changes in how they fit.)
• Bleeding or thickening lips.
• A swollen jaw.

What causes lip cancer?

Experts don’t know exactly what causes lip cancer. As with all cancers, errors in cell DNA cause normal cells to become cancer cells that multiply out of control. The abnormal cancer cells can spread and damage healthy tissue. Experts haven’t identified one single reason why cells behave this way. But they’ve identified several risk factors that people who get lip cancer share. Most have to do with lifestyle and environment.

Risk factors

Risk factors for lip cancer include:

• Tobacco use. This includes smoking cigarettes, cigars and pipes, and using snuff and chewing tobacco. Most lip cancers are linked to tobacco use.
• Heavy alcohol use. You increase your risk of lip cancer by up to 30 times if you use tobacco and also consume excessive amounts of alcohol.
• Excessive sun exposure. This includes exposure to artificial light in tanning beds.
• Having fair skin. People who are white with light features are most at risk.
• Being over 40. Most people get lip cancer in their 50s and 60s.
• Being assigned male at birth (AMAB). People AMAB are up to three times more likely to develop lip cancer than people assigned female at birth (AFAB).
• Having a weakened immune system.

How is lip cancer diagnosed?

Often, dentists or dermatologists spot lip cancer during routine exams. If a healthcare provider suspects lip cancer, they’ll ask about your medical history and habits, like whether you smoke. They may recommend diagnostic tests, including:

• Physical exam. Your healthcare provider will examine your lip and ask about your symptoms. They’ll also look at your mouth, face and neck to check for signs that the cancer has spread beyond your lips.
• Soft tissue biopsy. Your provider will remove a small sample of the affected tissue and send it to a pathology lab for testing. Results can show if a lesion or tumor is lip cancer.

If biopsy results show you have cancer, your healthcare provider may order additional tests to see if it’s spread. Advanced lip cancers metastasize, or spread to distant parts of your body. The good news is that most people get diagnosed before lip cancer spreads.

Tests include:

• Imaging tests. Your healthcare provider may take a CT (computed tomography) scan, a PET scan or use magnetic resonance imaging (MRI) to check for tumors.
• Endoscopy. During this procedure, your provider passes a small, flexible camera down your throat while you’re sedated to look for signs of cancer.

How is lip cancer treated?

The best treatment for you depends on the size of the tumor or lesion and the cancer stage. Often, healthcare providers can treat precancerous lip cancer (abnormal lesions that may become malignant) and early-stage lip cancer with surgery alone. You may need a combination of treatments if your condition is more advanced.

Lip cancer treatments include:

• Surgery. Your surgeon removes the lesion or tumor and repairs your lip. They may also remove lymph nodes in your neck if they suspect the cancer has spread there.
• Radiation therapy. This treatment uses radiation to kill cancer cells. Your provider may recommend external beam radiation therapy (EBRT) or brachytherapy (internal radiation therapy). Radiation therapy may be a standalone treatment, or you may need it after surgery to eliminate any remaining cancer cells.
• Chemotherapy. This treatment uses drugs to kill cancer cells. You may need chemo combined with radiation therapy. If your lip cancer has spread and no other treatments are available, your provider may recommend chemotherapy to ease your symptoms (palliative care).
• Targeted therapy. This treatment targets specific cancer cell genes and proteins, destroying them. People with lip cancer usually get it in combination with chemo.
• Immunotherapy. These drug treatments boost your body’s immune system and help it fight off cancer cells. For lip cancer, most people get immunotherapy when the cancer is advanced and other treatments aren’t an option.

Complications regarding lip cancer treatment

If you had surgery to remove a large tumor, you may need reconstructive surgery so your mouth looks like it did before. You may also need to work with a speech-language pathologist if you’re having trouble speaking or swallowing afterward.

If you’re worried about how you’ll look after surgery, remember that several procedures can help restore your appearance. Discuss your options with your healthcare provider before surgery to remove the tumor, so you know what to expect.

How soon after treatment will I feel better?

Recovery depends on several factors, including what type of treatment you get and how your body heals. People with early-stage lip cancer who have surgery typically recover within a few weeks. If you get radiation therapy or chemotherapy, it may take several months to fully feel like yourself again.

How can I reduce my risk for lip cancer?

Reduce your risk for lip cancer by avoiding common risk factors:

• Don’t use tobacco. Tobacco use is the leading risk factor for lip cancer and cancers of the mouth. If you smoke, consider quitting.
• Avoid heavy alcohol use. If you drink, do so in moderation. This means no more than two drinks a day for people AMAB, and no more than one drink daily for people AFAB.
• Protect yourself from the sun. Apply lip balm and sunscreen that’s at least SPF 30 anytime you’re outside (even on cloudy days). Whenever possible, plan outdoor activities outside the hours when you’re most likely to get direct sunlight. In the United States, you’ll get more sun exposure between 10:00 a.m. and 4:00 p.m.
• Avoid tanning beds. Steer clear of tanning beds, which can increase your risk of lip and skin cancer.
• Get routine oral cancer screenings. Your primary care physician or dentist can perform these screenings to check for abnormalities.

What can I expect if I have lip cancer?

Lip cancer is more predictable when you get treatment in the early stages, before it spreads. With an early diagnosis, you’ll likely need surgery to remove the lesion. Your healthcare provider may recommend chemotherapy, radiation therapy or other cancer treatments if the cancer cells have spread to other areas of your body.

Your healthcare provider can explain what to expect based on your diagnosis.

Does lip cancer spread quickly?

Squamous cell carcinoma (the most common type of lip cancer) tends to spread slowly. As it’s easy to see, most people notice the unusual growths on their lip and get checked before the cancer spreads.

Still, it can spread without treatment. See a healthcare provider if you’re noticing changes that you’re unsure about.

Is lip cancer fatal?

Not usually. Because lip cancer lesions develop in easily seen locations, this type of cancer is detected and treated early in most cases. As a result, lip cancer has an overall five-year survival rate of 91%. This means that 91% of people diagnosed with the condition are still alive five years later.

Keep in mind that survival rates are estimates. They can’t offer details about your case or tell you how long you’ll live. If you have more questions about survival rates, ask your healthcare provider.it

When should I see my healthcare provider?

You should schedule a visit with a healthcare provider if you notice changes in the skin on your lips. If you develop a sore on your lip that lasts for more than two weeks, call a provider right away.

What questions should I ask my healthcare provider?

Learning as much as you can about your diagnosis can help you make informed decisions about your treatment and overall health. Here are some questions you can ask your healthcare provider:

• What stage lip cancer do I have?
• Has the cancer spread beyond my lips?
• What are my treatment options?
• What side effects should I expect?
• How will treatment affect my daily life?
• Will I be able to work while getting treatment?
• What resources do you recommend?

Can you kiss someone with lip cancer?

Absolutely. You can kiss a loved one with lip cancer without putting your health at risk. Cancer happens because of problems with cell DNA inside a person’s body. You can’t catch it by hugging or kissing.