What Is Lip Cancer?

Lip cancer is an oral cancer that starts when the DNA inside a cell on the lip becomes abnormal. The abnormal DNA then causes the cells to grow and divide abnormally, resulting in a tumor, or group of abnormal cells.

The lips are lined with cells called squamous cells, which are the outermost layers of the lip. Cancer of the lip is most likely to develop in these types of cells and is called squamous cell carcinoma.

Lip cancer may also be a type of cancer called basal cell carcinoma, or it may be melanoma, which is cancer that develops in the melanocytes, the cells that give skin its pigment.

Lip Cancer Symptoms

The most common symptom of lip cancer is a sore on the lip that is not healing. This occurs most frequently on the bottom lip. This may look like an ulcer or a rough patch that is not getting better. 

Other symptoms that may be found on the lips include:

• A lump
• Skin thickening 
• Bleeding 
• Numbness 
• Pain 

Causes of Lip Cancer

Although lip cancer may have a known specific cause, there are certain factors that increase the risk of developing lip cancer. These risks include:

• Tobacco use
• Heavy alcohol use
• Exposure to the sun or other UV light
• Having light-colored skin
• History of human papillomavirus (HPV)
• Older than 40 years of age
• Male sex
• Immunosuppression

Diagnosing Lip Cancer

If cancer of the lip is suspected, a medical provider will often start by performing an exam of the lip and mouth for evaluation.

Ultimately, a biopsy is what is needed to diagnose lip cancer. During a biopsy, a piece of tissue from the suspicious area is taken off and sent to a laboratory, where it is analyzed for the presence of any abnormal cells. 

If a medical provider is suspicious that cancer has spread, they will order imaging studies such as computerized tomography (CT) or magnetic resonance imaging (MRI) for further evaluation.

Once a biopsy and all imaging studies are complete, lip cancer is given a stage.

Stage I

This is an early stage of cancer, and the tumor on the lip is less than 2 centimeters in size and has not spread into local lymph nodes. 

Stage II

Still an early-stage lip cancer, the tumor is between 2 and 4 centimeters in size and has not spread into local lymph nodes. 

Stage III

A more advanced stage of cancer, the tumor is more than 4 centimeters in size or is any size and has spread into lymph nodes in the neck. 

Stage IV

In this stage of cancer, the original lip tumor may be any size but has either spread into other nearby tissues (such as the jaw), has spread into multiple lymph nodes on the same side of the neck, has spread into any lymph node on the opposite side of the neck, or has spread into other organs in the body. 

Treatment of Lip Cancer

Multiple treatments for lip cancer are available, and treatment decisions are based on the type of cancer and the stage at which it is diagnosed. Treatments may include:

• Surgery
• Chemotherapy
• Radiation
• Immunotherapy

Surgery

The main form of treatment for lip cancer is surgical removal.

During the surgery, the lip cancer and some of the healthy tissue around it are removed. Sometimes lymph nodes in the neck are removed as well to check for cancer involvement.

Chemotherapy

Chemotherapy may also be required to treat lip cancer.

Chemotherapy is a medication that is given to kill cancer cells. It works by stopping cell growth at various points of their reproductive cycle. Chemotherapy can be given alone or in combination with radiation.

Side effects from chemotherapy vary depending on the specific chemotherapy medication being given. 

Radiation

During radiation, beams of X-rays are used to kill cancer cells.

For those with an early stage of lip cancer, radiation may be the only treatment required, with the goal of curing the lip cancer.

In later stages, radiation may be given in combination with chemotherapy or given alone to treat a painful symptom the cancer is causing.  Side effects of radiation may include:

• Dry mouth
• Pain with swallowing
• Loss of taste 
• Redness or pain to the skin
• Sore throat or mouth
• Feeling fatigued

Immunotherapy

Immunotherapy is not used for early-stage lip cancer, but in advanced stages where cancer has spread to locations outside of the lip.

Working differently than chemotherapy, immunotherapy helps a person’s immune system recognize and attack cancer. Typically immunotherapy is well tolerated but comes with the risk of autoimmune reactions. In an autoimmune reaction, the immune system attacks healthy cells, causing inflammation and side effects. 

Lip Cancer Prognosis

Often, cancer of the lip is found at an early stage, as it can be slow-growing and is in an area that is easily visible. When found at an early stage, cure rates are high, at over 90%.

The risk of recurrence of lip cancer is estimated at between 5% and 35%. If cancer is diagnosed at a more advanced stage, cure rates decrease to less than 50%.

Coping With Lip Cancer

Sometimes coping with lip cancer can be difficult. Depending upon the location and the treatment required, there may be a visible scar or a change in the ability to eat or swallow.

Being well informed about any treatment and potential side effects from treatment is one way to cope with the diagnosis. Having a good support system of people you can talk to is important as well. These may be family members, friends, or others who have the same diagnosis. 

A Word From Verywell

If you’re experiencing any symptoms that may be associated with lip cancer, it is important to have them checked out by a healthcare professional. Although being diagnosed with cancer can be scary, cancer of the lip has an excellent prognosis if found early.

Treatments for lip cancer can vary for each person, so be sure to ask your oncologist any questions you may have.

Be sure to find a good support system for yourself after being diagnosed with lip cancer, as a good support system or resources can help lift your spirits and get you through treatment.