Lip cancer occurs on the skin of the lips. Lip cancer can occur anywhere along the upper or lower lip, but is most common on the lower lip. Lip cancer is considered a type of mouth (oral) cancer. Most lip cancers are squamous cell carcinomas, which means they begin in the thin, flat cells in the middle and outer layers of the skin called squamous cells. Lip cancer risk factors include excessive sun exposure and tobacco use. You may reduce your risk of lip cancer by protecting your face from the sun with a hat or sunblock, and by quitting smoking. Treatment for lip cancer usually involves surgery to remove the cancer. For small lip cancers, surgery may be a minor procedure with minimal impact on your appearance. For larger lip cancers, more extensive surgery may be necessary. Careful planning and reconstruction can preserve your ability to eat and speak normally, and also achieve a satisfactory appearance after surgery.

Symptoms

Signs and symptoms of lip cancer include:

• A flat or slightly raised whitish discoloration of the lip
• A sore on your lip that won’t heal
• Tingling, pain or numbness of the lips or the skin around the mouth

Causes

It’s not clear what causes lip cancer.

In general, cancer starts when cells develop changes (mutations) in their DNA. A cell’s DNA contains the instructions that tell the cell what to do. The changes tell the cell to begin multiplying uncontrollably and to continue living when healthy cells would die. The accumulating cells form a tumor that can invade and destroy normal body tissue.

Risk factors

Factors that can increase your risk of lip cancer include:

• Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others
• Fair skin
• Excessive sun exposure to your lips
• A weakened immune system

Prevention

To reduce your risk of lip cancer, you can:

• Stop using tobacco or don’t start. If you use tobacco, stop. If you don’t use tobacco, don’t start. Using tobacco, whether smoked or chewed, exposes the cells in your lips to dangerous cancer-causing chemicals.
• Avoid the sun during the middle of the day. For many people in North America, the sun’s rays are strongest between about 10 a.m. and 4 p.m. Schedule outdoor activities for other times of the day, even during winter or when the sky is cloudy.
• Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.
• Avoid tanning beds. Tanning beds emit UV rays and can increase your risk of lip cancer.

Diagnosis

Tests and procedures used to diagnose lip cancer include:

• Physical exam. During a physical exam, your doctor will examine your lip, mouth, face and neck to look for signs of cancer. Your doctor will ask you about your signs and symptoms.
• Removing a sample of tissue for testing. During a biopsy, your doctor will remove a small sample of tissue for laboratory testing. In the laboratory, a doctor who analyzes body tissue (pathologist) can determine whether cancer is present, the type of cancer and the level of aggressiveness that’s present in the cancer cells.
• Imaging tests. Imaging tests may be used to determine whether cancer has spread beyond the lip. Imaging tests may include computerized tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET).

Treatment

Lip cancer treatments include:

• Surgery. Surgery is used to remove the lip cancer and a margin of healthy tissue that surrounds it. The surgeon then repairs the lip to allow for normal eating, drinking and speaking. Techniques to reduce scarring also are used.For small lip cancers, repairing the lip after surgery may be a simple procedure. But for larger lip cancers, skilled plastic and reconstructive surgeons may be needed to repair the lip. Reconstructive surgery may involve moving tissue and skin to the face from another part of the body.Surgery for lip cancer may also involve removing cancerous lymph nodes in the neck.
• Radiation therapy. Radiation therapy uses powerful energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy for lip cancer may be used on its own or it may be used after surgery. The radiation may be aimed only at your lip, or it may also be aimed at the lymph nodes in your neck.Radiation therapy for lip cancer most often comes from a large machine that precisely focuses the energy beams. But in some cases, the radiation can be placed directly on your lip and left in place for a short time. This procedure, called brachytherapy, allows doctors to use higher doses of radiation.
• Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. For lip cancer, chemotherapy is sometimes used in combination with radiation therapy to increase the effectiveness of treatment. In cases of advanced lip cancer that has spread to other areas of the body, chemotherapy may be used to reduce signs and symptoms and make you more comfortable.
• Targeted drug therapy. Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy.
• Immunotherapy. Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process. For cancer of the lip, immunotherapy might be considered when the cancer is advanced and other treatments aren’t an option.

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