Lip cancer is a type of head and neck cancer that develops on the skin of the lips when cells that make up the lip grow out of control and form tumors. It can occur anywhere on the lips, but it most often affects the lower lip.

Lip cancer is the most common cancer of the mouth, yet it only accounts for about 0.6 percent of all cancers in the United States, according to a review published in 2022 in Advances in Oral and Maxillofacial Surgery.

Cleveland Clinic reports that lip cancer has a high survival rate because it is often diagnosed and treated in the early stages of the disease.

Causes and Risk Factors for Lip Cancer

Doctors aren’t sure exactly what causes lip cancer, but they have identified some risk factors, which include:

• Tobacco use. This includes all forms of tobacco, such as cigarettes, cigars, pipes, chewing tobacco, and snuff.
• Heavy alcohol use.
• Excessive sun exposure.
• Fair skin.
• A weakened immune system.
• Being male.
• Having the human papillomavirus (HPV). HPV is a common sexually-transmitted infection.

Cleveland Clinic notes that most lip cancers are associated with tobacco use. When alcohol and tobacco are used together, a person’s risk of developing lip cancer is even higher.

Types of Lip Cancer

According to Moffitt Cancer Center, there are different types of cancer that can affect the lips, including:

• Squamous Cell Carcinoma This is the most common type of lip cancer. It happens when cancer develops in the thin, flat cells that line the lips and other areas of the mouth. Some studies suggest that more than 90 percent of lip tumors are squamous cell carcinomas.
• Melanoma This is a more aggressive type of skin cancer that can develop on the lips or inside the mouth.
• Lymphoma Rarely, lymphoma (a type of cancer of that affects immune cells called lymphocytes) can develop in the mouth.
• Basal Cell Carcinoma Research shows that this form of cancer more commonly affects the upper lip and is usually not aggressive.
• Minor Salivary Gland Cancer This type of cancer affects glands that produce saliva.

Penn Medicine points out that lip cancer is both an oral cancer and a skin cancer, but it’s usually treated as an oral cancer, depending on the location.

Signs and Symptoms of Lip Cancer

Lip cancer may cause the following symptoms:

• A sore on the lip that doesn’t heal
• Bleeding or crusty areas on the lips
• A flat or slightly raised whitish discoloration of the lip
• Pain, numbness, swelling, or tingling of the lips or the skin around the lips

Lip cancers look a lot like mouth sores. In individuals with darker skin, the sore might look dark brown or gray. In those with lighter skin, it may appear red. Some people mistake lip cancers for cold sores, but cold sores usually go away in about 10 days, whereas lip cancers will stick around.

How Is Lip Cancer Diagnosed?

To diagnose lip cancer, doctors may first perform a physical exam to look for signs of cancer. Memorial Sloan Kettering Cancer Center points out that dentists are often the first to notice indicators of lip cancer, during routine teeth cleanings.

According to Mayo Clinic, doctors may perform the following tests to help diagnose lip cancer:

• Biopsy A small piece of tissue is removed from the suspicious area to test in the lab. A pathologist can confirm whether the sample is cancerous.
• Imaging Tests Imaging tests can help doctors see if the cancer has spread beyond the lip area. Some common scans include computed tomography, magnetic resonance imaging, and positron emission tomography.
• Endoscopy If doctors think the cancer cells might have spread beyond the lip, they may recommend an endoscopy. This procedure involves inserting a small, flexible camera down your throat to look for signs of cancer.

Stages of Lip Cancer

After doctors diagnose lip cancer, they will assign it a stage, which describes the extent of the cancer in the person’s body. Staging cancer helps health providers recommend appropriate treatments and offer a correct prognosis.

Lip cancer is typically staged using the American Joint Committee on Cancer’s TNM (tumor, node, metastasis) system. TNM considers the extent of the tumor (T), whether it has spread to lymph nodes (N), and if it has metastasized (M) to other areas of the body.

Lip cancers may also be staged using a numeric system that ranges from 0 to 4. The higher the number, the more advanced the disease. For instance, a stage 0 lip cancer only affects the top layer of cells, whereas a stage 4 lip cancer may have grown into surrounding bone.

Treatment Options for Lip Cancer

The treatments that doctors recommend for lip cancer will depend on the type of cancer, the stage of the disease, and other factors. Treatments may be used alone or in combination, depending on the situation.

Surgery

Surgery is the most common type of treatment for lip cancer. Surgeons typically remove the cancer along with a margin of healthy tissue. Then, they might repair the lip so that patients can eat, drink, and speak normally. Sometimes, cancerous lymph nodes in the neck are also surgically removed.

If the cancer is large and invasive, plastic and reconstructive surgical techniques may be needed to restore the lip.

Radiation Therapy

Radiation therapy involves using powerful beams of energy to destroy cancer cells. Doctors may recommend radiation on its own or after surgery to target any leftover cancer cells.

Chemotherapy

With chemotherapy, drugs are given to kill cancer cells in the body. Chemo is sometimes used with radiation to bolster the effects of treatment. Or it may be given for very advanced lip cancers that have spread to other areas of the body, to lessen symptoms of the disease.

Targeted Therapy

Targeted therapy uses medicines that focus on specific proteins and genes of cancer cells that affect their growth. These treatments are usually combined with chemotherapy. Cetuximab is one targeted medicine that may be beneficial for people with advanced lip cancers, according to StatPearls.

Immunotherapy

Immunotherapy harnesses the body’s own immune system to fight cancer. This treatment is sometimes used for lips cancers that are advanced or when other treatments fail.

Complications of Lip Cancer

Lip cancer treatments can lead to the following complications:

• Lip, mouth, or facial disfigurement
• Problems with speech
• Nausea, vomiting, or fatigue
• Anemia (low red blood cell counts)
• Weight loss or loss of appetite
• Dry skin
• A sore throat
• Increased risk of infection

Lip Cancer Prognosis

The outlook for lip cancer is favorable if the disease is caught and treated early. According to the American Cancer Society, the five-year survival rate for lip cancer is:

• 94 percent for cancers that have not spread beyond the lip
• 63 percent for cancers that have spread outside the lip to nearby areas or lymph nodes
• 38 percent for cancers that have metastasized to more distant areas of the body, such as the lungs

Lip cancer can recur (come back) even after it’s been surgically removed, according to StatPearls. If this happens, the prognosis is usually worse, and the patient has a higher risk of death.

Research and Statistics: Who Has Lip Cancer?

Lip cancer is relatively uncommon. In fact, the American Cancer Society lists lip cancer as a rare type of cancer on its website.

Cleveland Clinic says that about 40,000 cases of lip cancer are diagnosed each year. To put that in perspective, the National Cancer Institute reports that about 0.1 percent of men and women will be diagnosed with lip cancer at some point during their lives.

According to the Advances in Oral and Maxillofacial Surgery review, 95 percent of lip cancer diagnoses are in men. The disease typically affects men between 50 and 70 years of age.

Screening and Prevention for Lip Cancer

There are no standardized routine screening recommendations for lip cancer, but the American Cancer Society recommends seeing a dentist for regular checkups that include an exam of the lip and mouth.

While there’s no definitive way to prevent lip cancer, certain habits may help lessen a person’s risk, including:

• Avoiding all forms of tobacco
• Limiting alcohol consumption
• Avoiding spending long periods of time in the sun
• Using sun protection, such as sunscreen and protective clothing
• Avoiding the use of tanning beds
• Protecting against HPV by getting vaccinated (if you are a candidate) and using condoms and/or dental dams during sex