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Lip cancer is a relatively rare cancer that most often affects elderly men. Lip cancer belongs to head and neck cancers. A typical feature of this group of cancers is the strong association with smoking. Lip cancer is usually located in places that are clearly visible - therefore, the diagnosis of lip cancer is usually made in the early stages of the cancer. Check the symptoms of lip cancer, what is lip cancer prevention and what are the treatments for lip cancer.

Lip canceris a rare cancer of the head and neck - the incidence in Europe is estimated at 12/100000. Lip cancer is caused by an abnormal growth of cells in the epithelium that covers the lip. These cells lose their normal structure and begin to multiply uncontrollably. The most common type of lip cancer is squamous cell carcinoma.

The biological features of this neoplasm are relatively slow growth and late metastasis to the lymph nodes. As a result, early detection of lip cancer is associated with a favorable prognosis. Lip cancer, like other head and neck cancers, is much more common in the male sex. The highest incidence is observed in patients between the ages of 50 and 70.

The most common location of lip cancer is the lower lip (about 90% of cases). Lip cancer is much less likely to be found on the upper lip (7%) and in the corners of the mouth (only 3% of cases).

Lip cancer - risk factors

Epidemiological data show that age (50-70 years) and male gender are significant risk factors for lip cancer. A characteristic feature of lip cancer is tobacco dependence, i.e. a connection with smoking cigarettes and other tobacco products (pipes, cigars).

Substances contained in tobacco smoke are carcinogens, thus increasing the risk of transforming he althy cells into cancerous cells. For head and neck cancers, including lip cancer, the risk is multiplied by smoking and drinking alcohol regularly.

Lip cancer can also develop from exposure to ionizing radiation or ultraviolet radiation (also from overexposure to the sun). An additional risk factor for lip cancer is infection with the human papillomavirus (HPV).

Lip cancer -prophylaxis

Knowing the factors that increase the risk of developing lip cancer, it is easy to understand the basic methods of preventing this cancer. Avoiding smoking and other tobacco products, as well as reducing the amount of alcohol consumed, seem to be the most important.

The carcinogenic effect of UV radiation can be reduced by using cosmetics with a filter on sunny days. Remember to also apply such cosmetics around the lips (lipsticks with UV filter are a good solution).

Lip cancer - symptoms

Lip cancer usually presents as a local ulcer or lump on the lip that does not resolve with medical treatment. Lip cancer is often accidentally spotted by dentists during a routine checkup.

Lip cancer can be exophytic (i.e. raised) or endophytic (i.e. hollow) depending on its shape. Lip cancer rarely causes pain. Lip cancer patients may report a feeling of numbness or tingling in the area around the lesion.

One of the characteristics of lip cancer is its slow growth, so do not delay seeing your doctor until the lesion is large. Each non-healing ulcer should prompt us to consult a doctor.

Since lip cancer is relatively easy to spot, it is usually found when it is locally advanced. A symptom of a higher stage of lip cancer may be enlarged lymph nodes in the neck area.

Infiltration of the surrounding organs of the head and neck may cause difficulties in chewing and swallowing food, as well as hoarseness or a change of voice. The generalized neoplastic process presents with marked weakness, chronic fever and weight loss. However, it is rare to find lip cancer at such a late stage.

Lip cancer - stages

The advanced classification of lip cancer includes 4 stages of this cancer, denoted by Roman numerals from I to IV. We can also meet with the diagnosis of lip cancer at grade 0. Such a marking indicates the so-called. cancer in situ, also known as pre-invasive cancer.

Neoplastic cells in lip cancer in situ are present only in the most superficial layers of the epithelium and do not cross its basal membrane. Carcinoma in situ is a very limited form of cancer and therefore offers the best chance of full recovery. A higher stage of lip cancer usually means a larger size of the primary lesion, infiltration of surrounding tissues or metastasis in lymph nodes and distant organs.

The stage of lip canceris based on the TNM classification, which is also used to describe the advancement of other neoplasms. The TNM classification takes into account three tumor parameters:

  • T (tumor) - size of the primary tumor
  • N (nodes) - local lymph node involvement
  • M (metastases) - presence of metastases in distant organs

For example, the stage of lip cancer described as T2N1M0 means a tumor 2-4 cm in size, a single metastasis in the lymph node on the side of the tumor ≤3 cm in size and no metastases in distant organs.

Lip cancer - diagnosis

The most basic method of lip cancer diagnosis is a clinical examination - any non-healing lesion in the lips should raise suspicion of cancer. In addition to a thorough examination of the area of ​​the primary lesion, the doctor conducting the examination will also assess the condition of the local lymph nodes (mainly cervical) for the presence of metastases.

The use of imaging tests in the diagnosis of lip cancer depends on the stage of the cancer. If the tumor is limited and small in size, additional examinations are not always necessary.

In the case of larger lesions or when there is a suspicion of infiltration of the surrounding tissues, imaging examinations of the head and neck are performed (most often computed tomography or magnetic resonance imaging). Cervical lymph nodes are imaged using ultrasound examination (USG).

These tests allow for an accurate assessment of the stage of the neoplasm, and are also useful in treatment planning. In the case of highly advanced neoplasms, tests are also recommended to locate possible distant metastases. For this purpose, among others, PET (Positron Emission Tomography) examination, which allows the visualization of tumor foci throughout the body.

In order to obtain a certain confirmation of the diagnosis of lip cancer, a histopathological examination by a pathologist is necessary. The material for examination may be the entire lesion removed during the surgery. In many cases, however, treatment is preceded by a biopsy, i.e. collecting a tissue fragment for examination.

Lip cancer - treatment

The choice of treatment method for each cancer depends on its biological characteristics and stage. The most common type of cancer of the lip is squamous cell carcinoma.

When planning the treatment of this cancer, it is worth knowing its characteristics - squamous cell carcinoma belongs to radiosensitive tumors, i.e. those that are sensitive to radiotherapy. In contrast, chemotherapy for squamous cell carcinoma is usually scarceeffective.

Surgical treatment is also very important in the treatment of lip cancer, as in the treatment of most types of cancer. In summary, the main treatments for lip cancer are surgery and / or radiation therapy.

The optimal treatment pathway for lip cancer may be slightly different for each patient. It is believed that low-stage cancer of the lip can be treated with the same effectiveness both with surgery and with radiation therapy. In radiotherapy of lip cancer, both radiation from external sources and the so-called brachytherapy. This is a type of radiation therapy that involves placing a radiation source in the immediate vicinity of the tumor. Thanks to this, it is possible to administer higher doses of radiation locally, without the side effects of damaging he althy tissues.

Higher stages of lip cancer usually require more complex surgical treatment. In oncological surgery, the removal of the entire tumor, including the margin of he althy tissue, is very important.

A highly advanced lip cancer may infiltrate the surrounding organs, incl. the lower jaw, neck muscles and the face area. In such cases, apart from tumor removal, it is also necessary to use plastic and reconstructive procedures, often with the use of tissue grafts from other parts of the body.

If lymph nodes are affected in the course of lip cancer, it is also advisable to perform the so-called lymphadenectomy, i.e. removal of neoplastic lymph nodes.

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Category:

Oncology