Lip cancer - causes, symptoms and treatment

Lip cancer - causes, symptoms and treatment

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Cancer tumors on the lip

Cancer has abnormal cells that have grown out of control. As a result, lesions or tumors (tumors) arise. The same applies to lip cancer. Here cells of the different tissue layers of the lips multiply excessively and cause lesions and tumors on the lips.

Lip cancer belongs to mouth and throat cancer

Lip tumors are associated with mouth and throat cancer. Around 10,000 people contract this disease in Germany every year. Most of those affected are between 55 and 65 years old and male (75 percent). However, the numbers among those affected by males have decreased in recent years. In women, on the other hand, the development is opposite and the incidence of lip cancer increases.

In most cases, tumors on the lip are malignant. But if treatment is started early enough, the chances of recovery are rated as very good. This is mainly due to the fact that the tumors grow very slowly and only develop metastases (daughter tumors) relatively late. For example, if the lip tumor is less than five millimeters, the chances of recovery are extremely promising at almost 100 percent.

Different types of lip cancer

There are also different types of tumors in lip cancer. In general, a distinction is made between benign (benign) and malignant (malignant) tumors. A tumor is considered benign if it does not form any colonizations (daughter tumors or metastases). Malignant cancers, on the other hand, tend to develop daughter tumors (metastasis) and thus to spread the cancer through the lymph channels throughout the organism.

If there is a malignant growth on one or both lips, doctors speak of lip carcinoma. The most common carcinoma is squamous cell carcinoma (spinalioma). This develops from certain thin, flat cells, the so-called squamous cells. The multi-layered squamous epithelium represents the outer area of ​​the lips. It lines the lips and covers the lip red. In addition to malignant tumors, benign lesions such as squamous papilloma can also emerge from the cells of the squamous epithelium.

Squamous papillomas arise in the majority of cases from infection with certain papilloma viruses (HPV 6/11). As from the squamous epithelium, tumors can develop from other cell layers of the lips. For example, carcinoma of the lips develops from the mucous membrane of the lips. This is often preceded by precancerous leukoplakia. Leukoplakia is a change in the redness of the lips and is considered a precancer (= precancerosis).

A basalioma is a tumor that emerges from the outer skin of the lips. The tumor usually shows locally infiltrating and destructive (destructive) growth. A slow-growing ulcer (ulcer) forms, which penetrates more deeply and into the surrounding structures. However, it very rarely forms daughter tumors.

How lip cancer can be recognized

Lip cancer develops very slowly in many cases and therefore does not cause any symptoms at first. The tumors are not uncommonly discovered by chance during a routine check-up at the dentist. The main risk factor is increased UV exposure. Since the lower lip is more exposed to sunlight than the upper lip, lip cancer mostly affects the lower lip. In rare cases, a tumor can also develop on the upper lip.

The tumor shows itself in the initial stage on the basis of non-erasable and very variable changes in the red lips (= leukoplakia or white calluses). The cells in this area cornify more strongly than the cells of the surrounding tissue. They can appear as whitish or dark spots or as wart-like structures. As the process progresses, the affected areas swell. An ulcer also develops, which does not heal even under therapy. Pain is also increasingly manifesting itself. Finally, dark red and slightly raised nodules appear.

Daughter tumors can develop in the advanced stage. Cancer cells reach other parts of the body via the lymph channels and form other tumors with additional accompanying complaints. Common complaints that are not directly related to the lips are, for example, swallowing and chewing problems and speech disorders. In general, malignant cancers - including lip cancer - can lead to chronic fatigue and / or significant weight loss.

The possible causes and risk factors

With regard to the causes and risk factors, what applies to skin cancer also generally applies here. The main cause is the additive accumulation of UV damage through excessive exposure to sunlight. For example, according to a Canadian study, farmers are three times more likely to develop lip cancer than people who work primarily in the office. Even with a fair complexion or fair skin, an increased risk is assumed, since this is more sensitive to ultraviolet radiation.

There are also some risk factors that can increase the likelihood of lip cancer. The toxic ingredients of tobacco smoke lead to repeated damage to the lip red. Regular and long-term consumption of high-proof alcohol is also considered a risk factor for lip cancer. In addition, immunosuppressed people are more likely to develop a lip tumor. Immunosuppression (= suppression of the immune system) is usually used after an organ transplant so that the transplanted organ is not rejected by the body's immune system. According to a study from 2009, the risk in people with immunosuppression after a kidney transplant is 30 times higher. The risk increases when the risk factors mentioned come together.

Improper nutrition with a low fruit and vegetable content, as well as a lack of vitamins or iron, is generally beneficial for the development of cancer. After all, poor oral hygiene can promote lip cancer. In the long term, bacterial or viral inflammation spots develop, which spread untreated, irritate the tissue and promote cancer in the long term.

Diseases with an increased risk of cancer

In addition, lip cancer can always develop on the basis of other cancers. Carcinomas of the oral mucosa and pharynx (oropharynx) as well as certain gum tumors (gingival carcinomas) can also spread to the lower lip in advanced stages. The precancerous stages - so-called precancerosis - for lip carcinoma also include:

  • Sun-induced lower lip atrophy (= chronic inflammatory change in the lower lip due to long-term exposure to light),
  • Keratoma senile (= wart-like structures or calluses on the face of older people),
  • chronic cheilitis actinica (= damage to the lip red due to chronic light damage),
  • Lichen planus (= inflammatory autoimmune disease affecting the skin and mucous membranes),
  • Bowen's disease (= early stage of white skin cancer),
  • Lupus vulgaris (= special form of skin tuberculosis),
  • Xerodermia pigmentosum (= moonlight disease, hypersensitivity of the skin to UV radiation)
  • and damage due to chemical, mechanical and thermal injuries

Regular inspection enables early detection

In particular, people to whom the above-mentioned risk factors apply should observe changes and injuries in the area of ​​their mouth and lip mucosa. Normally, mucous membranes heal extremely quickly and without problems. If, for example, an ulcer (ulcer), a wound after tooth extraction (= pulling a tooth) or a lip bite does not heal, these should be examined by a (dental) doctor. Even if an inflammation of the maxillary sinus (maxillary sinus) does not respond to the treatment measures carried out, a doctor should be consulted for safety reasons.

Overall, it makes sense to regularly inspect both the lips and the oral cavity. A lump or sore on one or both lips is not always the same as lip cancer. The changes on the lips should always be clarified with a doctor or dentist if they do not heal on their own.

The possible treatment methods for lip cancer

The doctor usually diagnoses lip cancer on the basis of a clinical examination. He examines the lips with magnifying glasses. Here he recognizes, among other things, the presence of leukoplakia as a characteristic change in the lip red. The diagnosis is confirmed using ultrasound or magnetic resonance and computer tomography. The pictorial representation also allows an accurate assessment of the tumor extent. A tissue sample (biopsy) can be taken under local anesthesia to determine the exact type of cancer based on the fine tissue analysis. Based on the findings, the exact therapeutic measures are finally planned.

As with other tumor diseases, the treatment depends on the type of cancer, the stage of the disease, the extent of the tumor and the general health of the person concerned. In most cases, cancer of the lip is removed as part of a surgical procedure to reduce the area of ​​the tumor. An attempt is made to cut out the entire tumor tissue. Thereafter, radiation therapy is usually used for larger tumors to kill the tumor cells that are still in the body. Before the procedure, radiation therapy is rarely used because the irradiated areas of the tissue tend to bleeding that is difficult to control during the operation.

Radiation therapy can also be carried out as an alternative and as a sole measure to tumor removal (surgical excision). Cryotherapy (= cold therapy) may also be possible for certain tumors. The tumor cells are treated with liquid nitrogen at -196 degrees Celsius. If these measures do not lead to the desired therapeutic result, chemotherapy can be initiated. Certain medications (cytostatics) are administered to the entire organism to prevent the tumor from spreading or recurring. In addition, in the case of advanced lip cancer, the adjacent lymph nodes are usually removed as a preventive measure to prevent the cancer from spreading through the lymph channels.

Alternative therapy measures

Today it is believed that the development of a cancerous tumor is promoted if certain control systems such as the body's immune system or the hormone system are impaired. These control systems are dependent on the one hand on the genes, but on the other hand also on the diet, the individual metabolism and certain environmental conditions.

As part of a so-called biological cancer therapy, deficiency states and imbalances within the hormone balance are eliminated and the function of the immune system is regulated to support these control systems. For this purpose, the individual hormone and immune status, the exposure to environmental toxins and reduced supplies of vitamins, minerals and trace elements are first determined on the basis of a clinical examination and with the aid of laboratory tests. A treatment plan is then drawn up together with the person concerned in order to remedy identified deficits and imbalances.

Possible treatment measures include nutritional advice, orthomolecular therapy (nutrient therapy), enzyme therapy, toxin removal, intestinal cleansing and vitamin C infusion therapy. The treatment measures mentioned should not replace conventional methods, but should complement them. They can also alleviate any side effects from radiation or chemotherapy.

Not every lip cancer requires therapy

Certain benign lip cancers such as squamous papilloma generally do not cause discomfort. Since these also have no increased risk of malignant degeneration (malignant transformation), no specific therapy is usually required here. However, cryotherapy (cold therapy), laser therapy or surgical removal of the lesion are available.

Plastic surgery for larger cancerous tumors

The removal of larger tumors is often accompanied by aesthetic impairments. As a rule, a tumor must be cut out of the surrounding healthy tissue at all levels with a safety distance of one centimeter. Therefore, following cancer therapy, a plastic reconstruction of the affected lips and face parts may be necessary (including flap plastic).

Psychological therapy support

The lips are an important sensory organ. With the lips, tones for linguistic communication are realized. They form the mouth opening and thus the entrance to the digestive tract. A cancerous growth in the area of ​​the lips can therefore be accompanied by considerable impairments of the facial expressions, articulation and food intake. Impairment of these functions can be a considerable burden for those affected. They often lead to restrictions in social life and other psychosocial consequences. Therefore, it often makes sense to provide psychological support to those affected. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


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ICD codes for this disease: C00ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.

Video: Mouth cancer. Spot cancer early. Cancer Research UK 2019 (October 2022).