Lip cancer

What is lip cancer?

Lip cancer, medically referred to as lip carcinoma, describes malignant tumors that develop in the lip region. It is one of the most common types of cancer affecting the oral cavity.

Malignant tumors are generally referred to as cancer. In such cases, cells undergo genetic mutations that cause them to grow and spread independently of external signals. This process displaces or infiltrates healthy tissue. If cancer cells gain access to the blood or lymphatic system, they can migrate to other tissues and form secondary tumors, known as metastases.

Approximately 15 out of 100 cancers occur in the oral cavity. In Germany, an average of 2 people per 100,000 inhabitants are diagnosed with lip cancer every year. It affects men more than women and the average age of onset is in the 6th decade of life.

In most cases, the outer third of the lower lip is affected. It is often a form of skin cancer, also known as squamous cell carcinoma.

How does lip cancer develop?

The exact reason a cancer develops cannot usually be precisely identified. Generally, a combination of factors causes cell changes and eventually malignant degeneration. In this connection, some risk factors have been identified that promote the development of cancer. However, it is important to note that these do not necessarily lead to the onset of the disease.

Major risk factors for oral cavity cancer in general are smoking and long-term excessive alcohol consumption. As the lips are in a very exposed area, unlike the rest of the mucous membranes in the oral cavity, excessive exposure to sunlight can be a significant risk factor. A major factor is the cumulative UV exposure the skin experiences over a lifetime, with frequent sunburns during childhood and adolescence potentially leading to issues later in life.

Additionally, poor oral hygiene can contribute to cell abnormalities. Current research is also investigating the role of human papillomaviruses (HPV). Certain types of this virus, for instance, are known to cause cervical cancer and are suspected of also influencing the development of lip cancer.

Which symptoms can indicate lip cancer?

Lip cancer rarely causes pain. Instead, the uppermost layer of the lips often changes, meaning that those who are affected generally notice this change as the first symptom.

The lips may become scalier or have a whitish coating. Reddening or wart-like thickening can also indicate cancer. The cancer usually spreads superficially before deeper layers of the skin are affected. Deeper skin defects such as non-healing wounds, may appear in later stages of the cancer. These are then often perceived as painful.

If the cancer has spread far, metastases can develop in other tissues. Lip cancer usually affects the lymph nodes in the neck area. Systemic symptoms such as night sweats, weight loss or fever may also occur.

How is lip cancer diagnosed?

The diagnosis of lip cancer typically begins with taking a detailed medical history, followed by a physical examination. During the history-taking process, questions are asked about the symptoms, their progression over time, and the presence of risk factors. This is then followed by a physical examination, with a particular focus on inspecting the lips.

A definitive diagnosis is made by taking a tissue sample and analyzing it through histological examination. Comprehensive cancer diagnostics also involve a process called staging, which assesses the extent, spread, and characteristics of the cancer cells to classify the disease into a specific stage.

As part of the staging process, imaging techniques are used to check for metastases. For lip cancer, this may also include an ENT (ear, nose, and throat) examination of the mouth and throat, as well as a dental check-up.

Once all the information about the disease stage has been gathered, it is reviewed in a tumor board. This interdisciplinary team considers the patient’s individual factors and creates a tailored treatment plan.

How do specialists treat lip cancer?

Cancer treatment consists of three main approaches: surgical removal of the tumor, radiotherapy and chemotherapy. Which procedure is used depends primarily on the stage of the tumor.

Smaller tumors are usually removed surgically. The lip can then be reconstructed by means of plastic surgery so that the lips can be used normally again.

If the tumor has already spread extensively, the cancer is usually treated with radiotherapy. After the tumor has been reduced in size, it can be surgically removed. Reconstruction of the lips can be somewhat more difficult in this case as a larger proportion of the tissue has usually been removed. It is important to ensure that the mouth can be opened sufficiently.

If the tumor has already spread and metastasized to the lymph nodes, these must also be removed. This mainly affects the cervical lymph nodes. If there is infiltration of the bony lower jaw, it may also be possible to remove a portion of it. Plastic surgery techniques are then used here too. Depending on the size and spread of the tumor, radiotherapy may be necessary after the operation.

Chemotherapy is rarely used in the treatment of oral cavity cancer. It is primarily used when the disease has progressed to the point where a curative approach is no longer possible. This is referred to as a palliative situation, where the focus is on improving the patient’s symptoms and maintaining their quality of life.

What are the chances of recovery and prognosis for lip cancer?

The prognosis for lip cancer largely depends on the stage of the disease. According to a large study conducted in 2005, the 5-year survival rate for patients in Stage I was 100%, meaning all patients survived for at least 5 years after diagnosis.

In Stage II, the 5-year survival rate was still high at 92%. However, the prognosis worsens as the cancer spreads. For patients with metastases in the cervical lymph nodes, the 5-year survival rate drops to approximately 50%.

Which doctors and clinics specialize in lip cancer?

The first point of contact for a lip cancer diagnosis is often dermatologists, as they frequently handle a significant portion of the diagnostic process. Specialists in oncology are responsible for treating cancer, supported by experts in radiation oncology and radiotherapy.

A cancer diagnosis is always a significant challenge for patients, including finding a skilled specialist. We aim to support patients in finding the right specialist for their condition.

All the doctors listed here have been carefully reviewed and selected. They are experts in their field with extensive experience in treating lip cancer. See for yourself the expertise of our specialists and easily schedule a first consultation.

Sources:

• Deutsche Krebsgesellschaft e.V. -https://www.krebshilfe.de/infomaterial/Patientenleitlinien/Mundhoehlenkrebs_Patientenleitlinie_DeutscheKrebshilfe.pdf
• Hiddemann, Bartram. Die Onkologie. 2. Auflage. Springer-Verlag. 2010.
• Amboss, Nachschlagewerk für Mediziner -https://next.amboss.com/de/article/Cj0qcT?q=mundh%C3%B6hlenkarzinom#Za909bad9156fb43677953447afc9ba5c