9 things to know about lip cancer

Lip cancer describes cancer that develops on the inside or outside of the lip. Anyplace from where the lips touch each other and inward is considered oral cancer. Anyplace from where the lips touch and outward is considered skin cancer.

We spoke to head and neck cancer surgeon Carol Lewis, M.D., to learn more about lip cancer, including what causes it, symptoms to look out for and how it’s treated. Here’s what she shared.

What is lip cancer?

First, it’s important to understand how we distinguish between the parts of the lip. The cutaneous (skin) part of the lip faces outward, and it starts where the lips meet. We refer to it as dry lip. The inner part of the lip is called the wet lip. Cancer on the dry lip is considered skin cancer, and cancer on the wet lip is considered oral cancer.

Most lip cancers start in the squamous cells, which line the surface of the mouth, tongue, gum and lips. Cancers on the wet lip are almost always squamous cell carcinomas.

What causes lip cancer?

Lip cancer can be linked to the following risk factors:

• excessive sun exposure (cancers on the dry lip)
• smoking and tobacco use (cancers on the wet lip)
• heavy alcohol use (cancers on the wet lip)

What are the symptoms of lip cancer?

The most common lip cancer symptom we see is an ulcer or sore that won’t heal. Viral ulcers are usually gone or improving within a couple of weeks. Lip cancer lesions can look like cold sores, but cold sores eventually heal. See a doctor if you have a lesion on the inside or outside of your lip that’s not getting better or is getting worse after two weeks.

Inside the mouth, you may also see white patches or red patches that appear more red than the surrounding lining of the mouth. This can also be a sign of lip cancer.

How is lip cancer diagnosed?

If you see a doctor for concerning symptoms, they will probably do a physical exam of your lips and mouth. Sometimes, dentists notice something unusual during routine exams or cleanings.

If your doctor suspects lip cancer, they will perform a biopsy. During a biopsy, a sample of tissue is removed and sent for testing. This is the only way to confirm a lip cancer diagnosis.

Does lip cancer ever spread?

Lip cancer can spread, but typically it doesn’t spread very quickly. It most often spreads to the lymph nodes in the neck. Sometimes it can spread to distant parts of the body, usually the lungs.

Is lip cancer curable?

Lip cancer is curable in many cases. We can cure lip cancer that is localized or even lip cancer that has spread to the lymph nodes.

When it spreads to other parts of the body, typically below the collarbone, then it’s usually not able to be cured. It can be treated, though.

How is lip cancer treated?  

Surgery is the standard treatment for lip cancer. A surgeon will remove the cancer and then repair or reconstruct the lip. Surgery to remove small lip cancers is usually simple and straightforward.

Sometimes, we use immunotherapy to treat lip lesions on the skin (dry lip). This can limit the amount of surgery a patient needs.

In some cases, we may also use radiation therapy in addition to either immunotherapy or surgery. For example, we may do radiation if the cancer is invading nerves. Or, if a patient has cancer in multiple lymph nodes in the neck, we may recommend radiation after surgery.

Are there any side effects from lip cancer treatment?

If you need lip cancer surgery, we’ll try to make sure you maintain your mouth function. This includes the ability to close your mouth, so you can eat and speak properly.

Larger lip cancers typically require more complex surgeries. That’s because larger lip cancers may require us to remove more of the lip(s), which can make the mouth smaller. In those cases, our plastic surgeons may perform reconstructive surgery.

At MD Anderson, we have plastic surgeons who focus on head and neck cancer patients. They always prioritize function when reconstructing the mouth. It’s not just about making your mouth look cosmetically better; we want to make sure you can use your mouth.

Speech involves movement of the lips, so your speech may also be affected. Even though your words may sound different, people can usually understand what you’re saying. MD Anderson's speech pathologists can work with you if you’re struggling with your speech as a result of treatment.  

Is there anything else you want newly diagnosed lip cancer patients and their families to know?

Lip cancer is highly treatable. Treatment may require us to balance cosmetics and function.

We encourage you to speak with your doctors and discuss your priorities. We take into account each patient’s preferences during treatment. Our goal is to get rid of the cancer and make sure you maintain a good quality of life after treatment.

Request an appointment at MD Anderson online or call 1-877-632-6789.