Medical Review By: Thomas Pham, MD
Your lips are important for lots of things, including chewing and kissing. While the occasional cold sore or cause of chapped lips is annoying, lip cancer is another story entirely.
Lip cancer in its early stages is hard to notice, but that’s when it’s most treatable. By the time a lip tumor becomes obvious, cancer requires more invasive treatment, and it may spread to other parts of your body.
If you get a lot of sun exposure, or you smoke, chew tobacco, or drink heavily, it’s time to learn how to spot it.
Types of lip cancer
Lip cancer usually takes the form of squamous cell carcinoma. This type of cancer occurs in the squamous cells, which are thin, flat cells found in the middle and outer layers of the skin. Squamous cell cancer of the lip is much more aggressive than squamous cell cancer found in other places of the skin. It’s more likely to spread to the head and neck and harder to treat.
Much less frequently, lip cancer is melanoma, one of the deadliest types of cancer.
Lip cancer symptoms
The lower lip is more vulnerable to lip cancer because it gets more sun exposure than the upper lip. Symptoms to watch for include:
- A sore, ulcer or lesion on your lip that doesn’t heal (a cold sore, unlike lip cancer, does heal)
- A lump or thickened area on the lip
- Whitish or reddish patches on the lip
- Lip pain, bleeding or numbness
- A lump in your neck or swollen glands
- Jaw swelling or tightness
A precancerous condition that can lead to squamous cell cancer of the lip is actinic cheilitis. Symptoms include:
- Scaly whitish patches on the lip
- Dryness or peeling that won’t heal
- A rough, sandpapery texture
- Blurring of the border between the lip and the adjacent skin
- Loss of color in the skin of the lip
- Swelling or redness of the lip
Who gets lip cancer?
UV radiation from spending a lot of time in the sun or using tanning beds is the leading cause of lip cancer. Certain habits, such as smoking or chewing tobacco and excessive drinking, also increase the risk.
Other risk factors for lip cancer include having a weakened immune system, having fair skin, being over 40 years old, and being infected with certain strains of human papillomavirus (particularly strains 16 and 18). Lip cancer is more common in men, possibly because they are more likely to work outdoors and less likely to use lip balm with SPF. They may also be more likely to have smoked or consumed too much alcohol in the past.
Recent research suggests that taking hydrochlorothiazide, a diuretic, is strongly associated with an increased risk of developing lip cancer. This drug is used alone or in combination with other medications to treat high blood pressure.
Lip cancer treatment
Lip cancer is usually curable; most people survive it and have a good outcome after treatment.
The doctor may recommend Mohs surgery to remove the tumor. In this procedure, the surgeon gradually removes layers of the tumor and a small amount of tissue surrounding it, checking each layer for cancer cells. The surgery ends when cancer cells can no longer be detected under a microscope. Mohs surgery lets surgeons identify and remove tiny roots of cancer, which helps prevent it from spreading to other parts of the body.
Advanced cases are usually treated by an ear, nose, and throat doctor (ENT). Radiation and/or chemotherapy may be used in conjunction with surgery. In rare cases, radiation “seed” therapy is used to treat patients who opt out of surgery. Reconstructive surgery may be necessary to repair the lip.
What you can do to prevent lip cancer
Protect your lips by following these tips:
Wear lip balm with SPF. Choose a lip balm with an SPF of at least 30 and wear it whenever you go outside. A wide-brimmed hat is also a good idea.
Don’t use tanning beds. Indoor tanning isn’t any safer for your skin than lying in the sun.
Limit or quit smoking and drinking. This is especially important if you drink and also smoke. These habits together put you at much higher risk for lip cancer than either habit alone.
See your dentist regularly. Dentists are often the ones to detect lip cancer, so keep up with routine cleanings and exams.
If you notice any unusual changes in your lip when you look in the mirror, don’t panic. But if something looks or feels different and the problem doesn’t resolve quickly, call your dermatologist ASAP. Treating lip cancer early means less risk of spoiling your smile.
Article Written By: Jessica Brown, a health and science writer/editor based in Brooklyn, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.
