The main treatment for lip cancer is surgery. The aim is to remove the tumour completely, together with a safe margin of healthy tissue around it, while preserving as far as possible the lip’s functions of speaking, eating and closing the mouth as well as its appearance. This page explains how the operation is planned, which methods are used and when the neck is included in treatment.
Planning before surgery
The decision to operate is made by considering together the biopsy result, the size and depth of the tumour, its position on the lip and the imaging of the neck. Your general health, the medicines you take and your smoking habits are reviewed; stopping smoking before the operation helps wound healing. You and your doctor discuss the plan for how much tissue will be removed and how the repair will be done.
Removing the tumour
- Wedge resection: In small tumours the affected part of the lip is cut out in a V or W shape and the lip is closed by stitching it directly.
- Vermilionectomy (lip shave): In superficial tumours confined to the red part of the lip, and in precancerous changes (actinic cheilitis), the red band is removed and the inner lining is advanced forward to create a new vermilion.
- Wide resection: In larger tumours a substantial part of the lip is removed, together with neighbouring skin or part of the jawbone where necessary. In this case the lip is rebuilt with the reconstruction methods described on a separate page.
Checking the surgical margins
During the operation the edges of the removed tissue can be examined by the pathologist to check whether any tumour cells remain (frozen section). If tumour is found at the edges, a little more tissue is removed in the same session. This approach aims both to ensure complete removal of the tumour and to avoid unnecessary loss of tissue.
The lymph nodes of the neck
Lip cancer tends to spread first to the lymph nodes under the jaw and beneath the chin. Treatment of the neck is planned in the following situations:
- If an enlarged, suspicious lymph node is found on examination or imaging, the relevant lymph node groups are removed by neck dissection.
- Even when the lymph nodes look normal, a selective neck dissection may be recommended if the tumour is large, deep or poorly differentiated, because of the possibility of hidden spread.
- In small, superficial tumours the neck is usually only monitored.
Additional treatments after surgery
If the pathology report shows findings such as close surgical margins, tumour spread around nerves or involvement of more than one lymph node, radiotherapy may be recommended after the operation. In some advanced-stage situations chemotherapy is added to radiotherapy. These decisions are made jointly at a tumour board where different specialties come together.
The early period after surgery
After the operation, swelling, tightness and temporary numbness of the lip are to be expected. In the first days you eat soft or liquid foods; the stitches are removed within a few weeks depending on wound healing. The recovery process after surgery is described in detail on a separate page.
Frequently asked questions
How much of the lip is removed in surgery?
Only the tumour and a safe margin of healthy tissue around it are removed; the amount depends on the size and depth of the tumour.
Are the neck lymph nodes removed in every operation?
No. In small, superficial tumours the neck is usually only monitored; in large or deep tumours, or when a suspicious lymph node is present, a neck dissection is planned.
Is radiotherapy needed after surgery?
It is not needed for most early-stage tumours; radiotherapy to complement surgery may be recommended when the surgical margins are close or the lymph nodes are involved.
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.