Lip Cancer

Lip cancer is a malignant tumor that develops on the lips, usually affecting the lower lip but sometimes occurring on the upper lip as well. As with other forms of cancer, early diagnosis is crucial in this disease. More common in men, the condition can be managed with advanced surgical procedures and oncological treatments.

The success of treatment depends largely on detecting the disease at an early stage. Therefore, regular check-ups and careful observation play a critical role in overcoming such health problems. In this context, raising awareness about lip cancer is of great importance.

In Istanbul, several doctors perform operations for lip cancer, including Prof. Dr. Murat Topdağ. By reading the information he has prepared, you can learn about the risks of lip cancer surgery, the recovery process, and what needs to be considered after the surgery.

Ear, Nose, Throat, Head and Neck Surgery Specialist
Prof. Dr. Murat Topdağ

Born in Malatya in 1978, Murat Topdağ completed his primary and secondary education, then attended high school in Istanbul. He graduated from the English program of Cerrahpaşa Tıp Fakültesi. Prof. Dr. Murat Topdağ is married and has two children.

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What is Lip Cancer?

Lip cancer refers to the malignant tumors that occur in the mucosa and skin of the lips. The disease typically appears on the lower lip but can also occur on the upper lip. Squamous cell carcinoma is the most common form, arising from the thin, flat cells in the middle and outer layers of the skin.

Excessive sun exposure and tobacco use are risk factors for lip cancer. The following measures can be taken to reduce the risk of lip cancer:

• Using sun protection methods.
• Avoiding tobacco products.

Treatment generally begins with surgery. Small lip cancers can be treated with minimal impact on appearance. Larger tumors may require more extensive surgical interventions. With reconstruction and careful planning, patients can maintain normal eating and speaking abilities.

They can also achieve a satisfactory cosmetic appearance. Advanced treatments can significantly improve health and aesthetics. For this reason, consulting doctors at an early stage about treatment options is highly important.

What Causes Lip Cancer?

Lip cancer is a disease in which malignant tumors form in the tissues of the lip. These cancers generally result from uncontrolled cell division due to DNA mutations. Multiple factors can trigger the condition.

First, smoking and other tobacco products represent a major risk factor. Additionally, excessive alcohol consumption is another key factor that can lead to lip cancer. These two habits cause harmful changes in the lip tissues and increase cancer risk.

Risk factors include:

• Smoking and other tobacco use
• Excessive alcohol consumption
• Long-term direct sun exposure
• Fair skin
• Male gender
• HPV infection
• Being over 40 years old

Such factors cause mutations in cells and lead to rapid division, ultimately resulting in unchecked cell growth in the lip area and the formation of tumors. In particular, fair skin is more vulnerable to the harmful UV rays of the sun, presenting a serious risk.

Men are more prone to this type of cancer, which is often linked to hormonal and biological differences. The presence of HPV infection can also contribute to the development of lip cancer. As a person ages, the likelihood of developing cancer increases, making it advisable for individuals over 40 to be more vigilant. Awareness of these risk factors and efforts to avoid them can reduce the risk of lip cancer.

What Are the Symptoms of Lip Cancer?

Lip cancer can present with various symptoms. Early on, the lips may develop a whitish discoloration. Over time, non-healing sores might appear in the lip area. This may be accompanied by tingling, pain, or numbness in the lips or in the skin around the mouth.

In some cases, lip cancer is only noticed during routine check-ups, indicating that the disease can be insidious. Although it can occur in any age group, it may not produce obvious symptoms in the initial stages.

Symptoms may include:

• Flat or raised, non-healing lip sores
• Bleeding lesions
• Severe pain
• Unexplained jaw swelling
• Tingling, pain, or numbness around the lips

Such signs could indicate the onset of lip cancer. On fair skin, lesions may appear red, while on darker skin they might be dark brown or gray.

Persistent sores and bleeding are significant warning signs. Swelling or pain in the jaw area could suggest that the cancer has progressed. Therefore, seeking medical attention promptly upon noticing these symptoms is essential.

How Is Lip Cancer Diagnosed?

Lip cancer can be cured if diagnosed early. The diagnostic process begins with reviewing the patient’s medical history and performing a physical examination. The doctor will examine lifestyle habits such as smoking and alcohol use, family medical history, and any previous dental treatments.

Physical Examination: The doctor inspects the mouth, lips, face, and neck area. If any abnormalities are detected, additional tests may be required.

Tissue Sampling: A small sample of suspicious tissue is collected and sent to a pathology lab for biopsy. This step is vital to confirm the presence and type of cancer.

Imaging Tests:

• CT scan
• MRI
• PET scan

These methods help assess how extensive the cancer is in terms of size and spread.

The doctor may also recommend further tests to check whether the cancer has spread to other parts of the body. This information clarifies the stage of the disease and shapes the treatment plan accordingly. Early diagnosis plays a vital role in successfully managing lip cancer, so it is crucial to consult a doctor without delay if you notice possible symptoms.

Lip Cancer Stages

Lip cancer is staged according to the American Joint Committee on Cancer (AJCC) TNM system, which classifies the disease by how far it has spread. In Stage 0, the cancer is limited to the topmost layer of cells; in Stage 1, the tumor is under 2 centimeters and has not invaded deeper tissues.

• Stage 2 means the tumor measures between 2 and 4 centimeters and does not extend into deep tissues.
• Stage 3 is characterized by a tumor larger than 4 centimeters or spread to the lymph nodes.
• Stage 4 is the most advanced phase, subdivided into further stages. Here, the tumor has spread to surrounding structures, especially the jawbone and nearby nerves. Stages proceed from 4A to 4B and 4C.

This classification system is fundamental for determining the treatment plan and prognosis. Each stage addresses different anatomical progression and therapeutic response, providing guidance for both doctors and patients.

How Is Lip Cancer Treated?

Lip cancer is a malignant tumor that begins in the lip tissue. Treatment varies according to tumor size, location, and the extent of spread. Possible treatment methods include surgery, radiation therapy, chemotherapy, targeted drug therapy, and immunotherapy. Each approach plays a significant role in combating cancer.

• Surgery is usually preferred in the early stages of lip cancer. The surgeon removes the cancerous tissue along with a margin of healthy tissue, increasing the likelihood of recovery. Reconstructive surgery techniques may be used to preserve lip function and enhance cosmetic appearance.
• Radiation therapy uses high-energy beams to destroy cancer cells. This is especially used after surgical removal of a tumor to target any remaining cancer cells, or in cases where surgery poses high risks.
• Chemotherapy involves powerful drugs that kill cancer cells throughout the body. In lip cancer, it is often administered alongside radiation therapy or as a standalone treatment in advanced cancer cases.
• Targeted drug therapy attacks specific molecular targets that contribute to cancer cell growth and spread. This approach is usually combined with chemotherapy to slow the progression of the disease.
• Immunotherapy boosts the immune system to help it fight cancer more effectively. This therapy shows promise, especially in advanced lip cancer that cannot be controlled through other methods.

When deciding on a treatment plan, factors such as the patient’s general health, the stage of the cancer, and its degree of spread are taken into account. The challenges patients face, including side effects of treatments and the recovery process, are managed by a multidisciplinary healthcare team that may include oncologists, surgeons, radiation therapists, and other professionals.

The treatment plan is tailored to the patient’s needs in order to establish the most effective strategy for fighting the disease.

Moral and psychological support are critical during treatment. Hence, counseling or support groups may be part of the treatment plan. Early detection is one of the most vital factors contributing to successful treatment outcomes in lip cancer.

Recovery After Lip Cancer Treatment

The recovery period following lip cancer treatment must be managed with care. Treatment may include surgery to remove the lip tumor. During this process:

• The tumor is excised,
• Restoration is done to leave minimal scarring aesthetically,
• Patient comfort is prioritized.

Depending on skin type, a scar may remain after surgery, but it often fades over time. The removal of lip tissue can slightly reduce the size of the mouth, yet this typically does not hinder the patient’s daily functions, such as eating and speaking. Early on, some slight articulation difficulties may occur, but these generally resolve as healing progresses.

When lip cancer is treated with appropriate surgery, relapse usually does not occur. Even if the disease returns, there is no need to despair.

With thorough and correct treatment, the majority of patients can make a full recovery. Effective communication between the patient and the doctor is vital for a successful healing process. Patients should inform their doctors about any challenges faced during recovery so that complications can be addressed promptly, making the healing period more comfortable.

Diet and Lifestyle Changes After Surgery

After lip cancer surgery, diet and lifestyle modifications are important. The patient needs to make dietary changes that promote overall health and accelerate the healing process. High-nutrient foods are recommended:

• Vegetables and fruits provide essential vitamins and minerals.
• Legumes and whole grains supply necessary fiber.
• These foods are also rich in antioxidants.

Processed food intake should be limited:

• Avoid red and processed meats.
• Do not consume sugar-sweetened beverages.
• Refrain from highly processed foods.

Hydration is very important:

• Adequate fluid intake must be ensured.
• Increase water consumption.

Soft foods can be included in the diet:

• Smoothies, soups, and purees are ideal for those who experience swallowing difficulties.

Lifestyle adjustments are also crucial. The patient should attend regular check-ups to detect any recurrences or complications at an early stage. Avoiding smoking and alcohol is imperative, as they increase the likelihood of cancer recurrence. Physical activity can support overall health and mental well-being. Patients are encouraged to engage in activities that boost psychological health:

• Joining support groups,
• Seeking counseling services.

Prevention of Lip Cancer

Preventing lip cancer requires examining personal habits. Stopping the use of tobacco products and reducing excessive alcohol consumption are key steps. Caution should be taken to avoid harmful effects of sunlight.

It is essential to avoid prolonged sun exposure and use sunscreen with a high protection factor. Tanning beds should also be avoided. These measures help reduce the risk of lip cancer.

Preventive measures include regular visits to the dentist, who can detect early lip cancer signs. Similarly, ENT (ear, nose, and throat) specialists play a significant role in diagnosis. Adopting a healthy lifestyle, including a balanced diet and sufficient sleep, improves overall health and lowers cancer risk.

After treatment, the following points should be considered:

• Have regular check-ups with your doctor.
• Maintain healthy living habits.
• Do not skip recommended tests.

Finally, lip cancer is not contagious, so there is no need to worry about social interactions. Exercise caution with herbal supplements and products, as taking them without medical guidance may interfere with the treatment process.

FAQ

Where Does Lip Cancer Spread?

Over time, lip cancer can spread to other parts of the body, a process called metastasis. The main sites where lip cancer tends to spread include:

• Lymph nodes under the jaw and in the neck. This is typically the first stop for cancer cells.
• Inside the mouth and the tongue. The cancer may directly invade these areas from the lips.
• Distant organs. In more advanced stages, lip cancer can even reach organs such as the lungs.

Each step in the spread of cancer cells can affect other bodily functions. Early diagnosis and treatment are vital to prevent the cancer from advancing. Thus, noticing unusual changes in the lips and consulting a doctor promptly is of great importance.

Is Lip Cancer Fatal?

Lip cancer usually has a relatively low fatality rate. Early detection is key to successfully treating this type of cancer. Because lesions on the lips are visible, there is a high likelihood of identifying the disease early. This advantage allows timely intervention.

Accordingly, lip cancer can typically be controlled and treated. However, as with any type of cancer, it is essential to take lip cancer seriously and undergo all necessary medical evaluations promptly. Doing so can help prevent potential complications and minimize long-term effects on health.

Which Department/Doctor Should I Consult for Lip Cancer?

Lip cancer is a serious health issue. When its symptoms are noticed, the first step is to visit an Ear, Nose, and Throat (ENT) specialist. These doctors play a key role in diagnosing and treating the condition.

They perform the relevant examinations and tests, and decide on the most suitable treatment plan for the patient. ENT specialists possess specific training and expertise in this area. If a multidisciplinary approach is needed for lip cancer, oncologists may also collaborate with them.

• ENT Specialist: Central in diagnosing and managing the disease.
• Oncology Specialists: May be involved in cases that require more complex treatment.

Such specialists enhance the chances of early detection and effective treatment for lip cancer.

Is Lip Cancer Genetic or Contagious?

Although lip cancer can be associated with genetic factors, it is not an infectious disease transmitted from one person to another. The way lip cancer develops is often misunderstood. Lifestyle choices and environmental factors, such as smoking and overexposure to the sun, are major contributors to lip cancer risk. However:

• A hereditary predisposition can be one of the risk factors.
• There is no scientific evidence suggesting that cancer of this kind is contagious.

Lip cancer does not spread through shared air, handshakes, kissing, or sexual contact with a person who has the disease. Hence, raising awareness is crucial to prevent misconceptions. Each individual should take steps to minimize risk factors, which is an effective approach to combating lip cancer.

What Happens if Lip Cancer Is Left Untreated?

Untreated lip cancer can lead to serious health issues. Initially, it often appears on the upper portion of the lip or near the corners.

Over time, cancer cells may multiply rapidly, forming ulcers, which in turn allows the disease to progress more quickly. Additionally, the cancer can spread into the jawbone, making treatment more difficult and harming overall health.

In cases of lower lip cancer, the cancer’s growth may spread to the neck, depending on the tumor’s size. Such dissemination complicates treatment and can cause the disease to affect other areas. Thus, early diagnosis and treatment of lip cancer are critical to preventing it from spreading and achieving better health outcomes.

Does Lip Cancer Go Away on Its Own?

Lip cancer is a serious health condition requiring medical intervention. In general, early diagnosis and appropriate treatment methods can lead to successful recovery. Relying on the disease to resolve itself, however, is extremely risky.

During the treatment process, proper attention should also be paid to the neck region. Preventing the cancer from spreading is of paramount importance. For this reason:

• Early diagnosis,
• Proper treatment,
• Addressing the neck area,

are all key in overcoming lip cancer. If neglected or left untreated, the disease can have severe repercussions. Therefore, it is essential to closely follow doctors’ recommendations throughout treatment.

At What Ages Does Lip Cancer Occur?

Lip cancer tends to be more common in people exposed to certain risk factors. In particular, it appears more frequently in individuals over the age of 40. The harmful UV rays of the sun increase the likelihood of developing this cancer, putting those who work outdoors at higher risk.

Tobacco and tobacco products are also key triggers for lip cancer. Although it is more common in fair-skinned men, the disease can also affect women.

• Major risk factors include:
• Prolonged sun exposure
• Tobacco use
• Fair skin

Although considered more prevalent in men, women are not exempt from the risk of lip cancer. It is important for everyone with risk factors, especially those over 40, to attend regular medical check-ups.

Does the Lip Swell in Lip Cancer?

In the early stages, lip cancer often manifests as minor swelling. Over time, the swelling can increase and potentially involve the jaw area. As lip cancer advances, the lips and surrounding tissues may become more visibly swollen. This local swelling is considered a direct effect of the tumor.

Who Performs Lip Cancer Surgery?

Lip cancer surgery is generally carried out by ENT specialists and plastic surgeons. If a physician is qualified, they may also perform a neck dissection. Patients should confirm whether the treatment plan involves neck dissection. It can be beneficial to choose an ENT doctor experienced in head and neck cancers.

Does Avoiding Inhaling Smoke Still Cause Lip Cancer?

Even if you do not actually inhale the smoke, lip cancer risk can increase if cigarette smoke comes into direct contact with the lips. This is because cigarette smoke contains carcinogenic chemicals that can damage the DNA of lip cells, leading to cancer. Therefore, allowing cigarette smoke to contact the lips increases the risk of lip cancer.

Can I Recognize the Onset of Lip Cancer Myself?

No, a person cannot definitively identify lip cancer’s onset on their own. While being aware of possible symptoms is valuable, a health professional must provide an accurate diagnosis. If suspicious symptoms appear, seeing a doctor is the best course of action. A professional examination clarifies the situation and determines necessary treatments.

Does Lip Cancer Spread?

Yes, lip cancer can spread. If left untreated, this type of cancer may progress to other areas of the mouth, such as the tongue, and can even spread to more distant regions of the body. When lip cancer is not addressed early, treatment becomes more difficult.

What Are the Initial and Early Signs of Lip Cancer?

Non-healing sores are among the earliest indicators of lip cancer. These sores may look like crusty or scaly patches, ulcers, or lumps on the lips. A flat or slightly raised whitish discoloration can also appear. If these changes persist or worsen over time, they may indicate lip cancer. Additionally, tingling, pain, or numbness in the lips or around the mouth can appear in the initial stages of the disease. Though uncommon, bleeding of the lips may also signal possible lip cancer.

Is There a Chance of Survival in Stage 4 Lip Cancer?

When lip cancer reaches Stage 4, the five-year survival rate generally decreases, often falling below 40.4%. However, this rate can vary depending on the specific treatment the patient receives and how far the cancer has spread to other organs. Each case must be evaluated individually. At this stage, treatment typically aims to slow the disease’s progress and improve the patient’s quality of life.

Looking at images of people with lip cancer is not a reliable way to self-diagnose. If you suspect any concerning symptoms, please seek professional medical advice.

References:

https://my.clevelandclinic.org/health/diseases/21933-lip-cancer

https://www.mayoclinic.org/diseases-conditions/lip-cancer/symptoms-causes/syc-20355079

Prof. Dr. Murat Topdağ