Because lip cancer develops in an easily visible part of the body, its symptoms can often be noticed at an early stage. However, the first signs can be mistaken for ordinary problems such as cold sores, cracks or sunburn, and this can lead to delays. This page explains which signs to look out for and how the diagnosis is made.
Early symptoms
The most typical sign of lip cancer is a sore that should have closed within a few weeks but has not healed. Other changes that may be seen early on:
- An area on the red part of the lip (vermilion) that crusts, peels and keeps reopening
- A whitish (leukoplakia) or reddish (erythroplakia) patch
- A rough, firm or thickened area on the lip
- A small bump that bleeds even with light touch.
Advanced symptoms
As the tumour grows, the symptoms become more pronounced:
- A palpable lump on the lip, or firmness spreading into the surrounding tissue
- Pain, burning or numbness in the lip
- Difficulty moving the lip or closing the mouth
- A palpable swelling under the jaw or in the neck (enlarged lymph node)
- Loosening of the teeth or pain in the jaw; these findings may suggest that the tumour has reached deeper tissues.
Precancerous changes
Long-term sun exposure can lead to a condition of the lip called actinic cheilitis, in which the lip becomes dry, cracked and discoloured. This is not cancer in itself, but it prepares the ground for cancer to develop over time; regular follow-up and sun protection are therefore important.
Examination
The diagnostic process begins with a careful examination of the lip, the inside of the mouth and the neck. The doctor assesses the size and depth of the sore, whether it is fixed to the surrounding tissues, and whether it extends to the corners of the mouth (commissures). The neck is examined by hand to look for enlarged lymph nodes.
Biopsy
A definite diagnosis can only be made by biopsy. Under local anaesthesia a small piece of tissue is taken from the suspicious area and examined in the pathology laboratory. In small lesions the whole lesion may be removed during the biopsy (excisional biopsy). The result reports the type of the tumour and how differentiated its cells are (its grade).
Imaging
Imaging methods are used to assess the depth of the tumour and the lymph nodes of the neck:
- Neck ultrasound is the first-choice method for examining the lymph nodes
- Computed tomography (CT) provides information when spread to the jawbone is suspected
- Magnetic resonance imaging (MRI) helps to show soft tissue and nerve involvement
- When advanced disease is suspected, whole-body scanning (PET-CT) may be requested.
When should you see a doctor?
If a sore on your lip has not healed for several weeks, if it crusts over and reopens, or if you have noticed a new swelling in your neck, it is advisable to be examined. Most of these findings are due to benign causes, but only an examination and, where needed, a biopsy can make the distinction.
Frequently asked questions
How can a lip sore be distinguished from a cold sore?
A cold sore heals on its own within a short time; a sore that lasts for weeks, crusts over and reopens needs an examination and, if necessary, a biopsy.
Is a biopsy painful?
A biopsy is a short procedure performed under local anaesthesia; no pain is felt during the procedure, and there may be mild tenderness afterwards.
Does every patient need imaging?
For small, superficial lesions examination and biopsy may be enough; imaging is requested when the lymph nodes of the neck and the depth of the tumour need to be assessed.
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.