Lip cancer is a malignant tumour that develops on the red part of the lip (vermilion), the transition zone between the skin and the lining of the mouth, or on the surrounding skin. It is one of the most easily visible head and neck cancers and is often noticed at an early stage. This page outlines what lip cancer is, who is more likely to develop it, how it is diagnosed and what the treatment options are.
What is lip cancer?
The lips are covered by skin on the outside and by the lining of the mouth (mucosa) on the inside; the red band between the two is called the vermilion. The great majority of lip cancers are squamous cell carcinomas, which arise from the flat surface cells of this area. The lower lip is affected far more often than the upper lip because it receives more sunlight. Tumours of the upper lip and of the corners of the mouth (commissures) are less common but may need closer follow-up.
Why does it develop?
Lip cancer cannot be traced to a single cause; a combination of factors raises the risk:
- Unprotected sun exposure over many years, especially in people who work outdoors
- Smoking, pipe smoking and chewing tobacco
- Alcohol use combined with tobacco
- Fair skin and a tendency to burn easily in the sun
- Diseases or treatments that suppress the immune system
- Long-standing cracks on the lip that do not heal, or sun-related precancerous changes known as actinic cheilitis.
Symptoms
The most common symptom is a sore on the lip that does not close even after several weeks. Other findings that may accompany it include:
- An area that crusts, peels or bleeds from time to time
- Firmness, thickening or a whitish patch on the lip
- Numbness or pain in the lip
- A palpable swelling under the jaw.
Diagnosis
Diagnosis begins with a careful examination of the lip and the inside of the mouth. Taking a small tissue sample from the suspicious area (biopsy) is necessary for a definite diagnosis. Ultrasound, and where needed computed tomography or magnetic resonance imaging, may be requested to assess the lymph nodes of the neck.
Treatment options
The main treatment for lip cancer is surgical removal of the tumour together with a margin of healthy tissue around it. In small tumours the resulting gap is usually closed in the same session; after wider removals the lip is repaired with flaps prepared from neighbouring tissue. If the cancer has spread to the lymph nodes of the neck, or if this is considered likely, a neck dissection may be added. In some situations radiotherapy is used on its own or to complement surgery.
When should you see a doctor?
If you notice a sore, crusting, firmness or bleeding on your lip that has not healed for several weeks, it is advisable to see an ear, nose and throat and head and neck surgeon without delay. Lip lesions assessed at an early stage are treated with a smaller operation, and the shape and function of the lip are better preserved.
Frequently asked questions
Why does a sore on the lip that does not heal matter?
A lip sore that does not close for weeks, crusts over or bleeds can be an early sign of cancer and needs to be examined.
Who is most likely to develop lip cancer?
It is more common in people who have worked in the sun for many years, in tobacco users and in fair-skinned people; the lower lip is the area most often affected.
Can lip cancer be treated?
A lip cancer caught at an early stage is usually treated with surgery alone, and every effort is made to preserve the appearance and function of the lip.
This page is general information. Decisions about diagnosis and treatment are made for you personally, and only after an examination. If you have symptoms, see a doctor.