Lip cancer - primary diagnosis | Health Prevention
 
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Lip cancer

The group of cancers of the upper digestive tract includes such diseases as

  • lip cancer
  • pharyngeal cancer
  • salivary gland cancer
  • larynx cancer
  • cancer of the tonsils
  • cancer of the tongue
  • cancer of the oral cavity
  • nasal cancer
  • sinus cancer

 Lip cancer accounts for about 15% of oral cancers.

Lip cancer mostly affects either the mucous membrane of the lower lip or the red border of the lips.

This type of cancer is usually preceded by a precancerous condition that appears as an ulcer or white lesion (leukoplakia or cheilitis inflammatory lip). In most cases it is a hardened lesion that bleeds on contact and can be either painless or uncomfortable.

Among the most common pre-cancerous conditions of the lip, keratotic white lesions are the most common. Early treatment should prevent its degeneration.

Malignant growths in the corners of the mouth have similar characteristics to inner-cheek cancers and skin cancers.

Lip cancer can be of different types

Most cases of lip cancer are squamous cell carcinomas, which occur mostly on the lower lip, on the red border of the lips, or on the upper part of the mucosa (much less often on the white lip). On the mucous membrane side, salivary gland carcinomas also occur.

Basal cell carcinomas are less common and usually develop on the skin of the upper lip.

Their treatment is similar to other upper-lip cancers and includes a search for secondary cancers.

Other malignant tumors of the lip are less common, among which melanomas (and its precancerous condition, Dubreuil melanoma in situ) predominate. Their diagnosis and therapy are identical to the diagnosis and therapy of cutaneous or mucosal melanomas of other localizations. Other cancers occur on the lips, particularly Merkel’s tumor and dermatofibrosarcoma of Darié and Ferrand.

Causes of lip cancer

Like other cancers, such as tongue cancer, lip cancer is contributed to :

– Smoking, especially pipes or cigarettes that are smoked all the way through

– Excessive consumption of alcohol

– Poor oral hygiene

– Local trauma and chronic irritation

– Climatic conditions (working in the sun with no lip hygiene protection)

However, lip cancer also has specific causes that can be distinguished from those of other ENT cancers. Indeed, the outer part of the lips is exposed to external factors such as the sun’s ultraviolet rays, cold, wind, etc. That is why lip cancer (which is a type of skin cancer) develops mainly in people who are very exposed to these aggressive influences (farmers, fishermen, etc.).

Men are more often affected by lip cancer than women, because they are not used to protecting their lips with appropriate hygiene products.

Diagnosis of lip cancer

The diagnosis of malignancy is made on the basis of an anatomopathologic examination after examining a biopsy of the tumor.

In the postoperative situation, several criteria are needed to make a decision about adjuvant therapy:

– Determine the type and size of the tumor

– Whether the tumor has metastasized to muscle, bone, and skin

– Limits of invasion, margins <5 mm, severe dysplasia, carcinoma in situ) with location if possible

Treatment of lip cancer

Treatment for lip cancer is primarily based on surgery, radiation therapy, or a variation of it, brachytherapy.

In general, if the diagnosis of lip cancer is made at an early stage, the prognosis is very favorable: the 5-year survival rate is 92%.

Surgery

Surgery performed by an ENT surgeon requires removal of the lesion with a margin of one centimeter of healthy tissue around the lesion, both superficially and deeply. In the case of such surgery, reconstructive surgery is systematically scheduled, especially for lip cancer larger than 3 cm.

In addition, it is sometimes necessary to consider removing nearby lymph nodes. However, because lymph node involvement in lip cancer is less than 10% for stage 1 T1 tumors and only 25% for T2 tumors, simple observation is usually chosen. In contrast, patients with stages N1 and N2 (with lymph node metastases on the same side as the tumor) will require lymph node excision.

Radiation therapy

Radiation therapy may be required to treat large lip tumors (T3 and T4 stages). However, it is usually used as an adjunct to surgery after removal of the lip cancer and affected lymph nodes.

Brachytherapy with iridium-192 under meth anesthesia may also be administered to the patient. This therapy consists of injecting iridium directly into the tumor. The treatment lasts from 3 to 5 days, the patient must be hospitalized in a separate room. This method gives excellent results for small tumors (stage T1, T2) with a 5-year survival rate of over 90%.

Chemotherapy

Chemotherapy may be offered in the presence of factors that give a poor prognosis, i.e. stage III and IV.

Stage T4 lip cancer can metastasize to the bone, gums, lower part of the mouth, or skin of the face.

 

How do I follow up after treatment?

After lip cancer treatment, clinical exams should be done every three months for two years and then every six months for three years to make sure there is no recurrence or lymph node disease or development of secondary cancer.

The patient should be seen by various specialists: an ENT doctor, a dermatologist, and a dentist (or orthodontist).

 

Oral cancer is one of the most preventable cancers. Early detection and observation of certain signs can detect the disease and greatly increase your chances of recovery.

Early diagnosis of lip cancer

Early diagnosis of all cancers is vital because lip cancer is almost always curable if detected and treated early. Your lips should be checked regularly for skin changes, such as sores, white or red patches, which can be signs of cancer.

See your dentist to have your mouth checked for oral cancer. If your doctor notices any changes or signs of cancer, he or she will take a biopsy and send the material to the lab to look for cancer cells.

Early diagnosis and treatment of melanoma is necessary to prevent the disease from spreading to other parts of the body. Once diagnosed, your doctor will develop a treatment plan.

 

At our Health and Prevention Center, you can :

– Be examined by our dentist, and he or she will examine your mouth for an initial diagnosis of lip and oral cancer

– Get diagnosed by one of Europe’s best dermatologists, Professor Ockenfels.

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