The oral cavity consists of the lips, mouth, tongue and tonsils. Cancer of the lip or oral cancer is a disease where malignant cells appear on the tissues of the mouth or lip. Although there are many different cells in the lips and oral cavity, those that usually get infected are the squamous cells.
Cancer of the lip looks like open sores on the mouth. Oral or lip cancers cause at least 8000 deaths a year in the US alone and usually affect people beyond 50 years (especially men). Tobacco and alcohol use are the two highest causes for lip cancer. Tobacco use here refers to all forms – cigarettes (more than 2 packs daily), pipes, cigars, dipping snuff, and chewing tobacco. Hereditary factors could also be a cause but not clearly understood.
Chronic alcoholics (> 6 drinks per day) are also at risk of contracting lip cancer. A combination of both alcohol and smoking is more likely to cause lip cancer than just one or the other. Other risk factors include using a mouthwash with high concentrations of alcohol, those who have already had lip cancer, HPV virus, irritation from broken teeth, sharp fillings, dentures and untreated syphilis and exposure to the sun or artificial tanning lights for long periods.
Symptoms of Lip Cancer
Like many other diseases, symptoms of lip cancer resemble other conditions.
Sores or an ulcer inside the mouth or on the lip that does not heal is one of the first symptoms. The sores usually appear on the lower lip in most of lip cancer cases. According to the American Oral Cancer Clinic, this non-healing ulcer will be found at the intersection of the middle and outer third of the patient’s lower lip and feels rock hard. The ulcer feels like it is attached to the tissues lying beneath them.
Lump: You can even have a lump on the lip or inside the throat or mouth and the lips will look thick and swollen. Those who chew tobacco can develop bumps, which are white and rigid on the inner sides of the cheeks. If left untreated, these develop into verrucous (warty) cancer.
White patches or discolored areas may appear on the tongue, gums or mouth lining. Sometimes, darkly discolored or brown areas appear on the lips or mouth. A smoker’s patch (flat, brown, freckled area) appears on the site where a person habitually holds a cigarette, pipe etc.
Unusual lip bleeding accompanied with pain and numbness (loss of sensation) of the lips and in the mouth is another symptom.
Numbness indicates that the lip cancer has spread and is slowly eroding the underlying nerves. Numbness of the lips occurs when the nerves get compressed and have no sensation.
Sore throat: You can have an inflamed and painful throat that is persistent and does not respond to conventional treatments.
Choking: Some people may experience a kind of choking feeling like something has got caught in the throat.
Swallowing and chewing of food can become difficult and painful due to swelling of the lymph glands on the affected lip.
Swollen jaw: Your jaw could become swollen with no external signs of injuries.
Change in Voice: Some people could experience a change in their voice. E.g. Your voice could suddenly become hoarse (like when you have a sore throat) but does not respond to usual treatment.
Earache: You could develop symptoms of earache.
Dentures: Those who have dentures fitted and have had no problem could suddenly find that they do not fit properly, give pain etc. Your teeth can also become suddenly loose.
Swollen Neck glands: These could become swollen when lip cancer has spread to the neck and surround lymph glands. The doctor examines the neck region to feel for lumps.
What to do?
Since any or all the above could be symptoms of lip cancer, people who experience them and find they do not respond to conventional medications and persist for a long time, need to consult a doctor immediately. Sometimes those who have oral or lip cancer may not display any symptoms and the presence of cancer may only be revealed during a routine dental examination.
Treatment of lip cancer
The doctor will first perform an external examination of the mouth and lips using mirror and lights. If needed, he will order an X-ray of the mouth and lip tissues. If these do not look normal, he will perform a small biopsy and remove some tissue. This will be examined for cancer cells. He will also examine the throat for swollen glands. If the cancer is just on the lips or mouth, the chances of recovery are good, especially if the overall health of the patient is good.
When a person demonstrates the symptoms of lip cancer and the biopsy comes positive, then several treatment options will be used.
Radiation and surgery are the two main options for lip cancer. When you undergo surgery, the extent of spread of the cancer will be determined and tissues and glands removed accordingly. Hence, surgery for lip cancer is potentially disfiguring. Newer surgery techniques like the Mohs technique for lip cancer and laser techniques to kill cancer cells both minimize disfigurement. People can undergo reconstructive surgery once the cancer has been controlled. Prosthetic devices replace jaw parts and teeth that have been removed during surgery.
Radiation sometimes destroys salivary glands causing dental problems like cavities. Chemotherapy is rarely used to treat lip cancer since it is not very effective. Patients who are too weak to undergo radiation or surgery will be given drugs.
Lip cancer : Prevention and Precaution
Cancers of the lips and oral cavity can quickly spread to the lymph nods. Those who have squamous cell cancer can recover completely if all the cancerous cells and surrounding tissues are removed early before they spread to the lymph glands. In such cases, 68% survive for 5 years and more. If the cancer has spread, only 25% are likely to survive for 5 years or more.
Since the main cause for lip cancer is excessive smoking and alcohol use, it is possible to prevent this cancer by stopping these two deadly habits. Diligent and routine dental exams can catch the symptoms of lip cancer early to enable quick treatment. Another preventive measure is to ensure you do not have sharp teeth that injure the insides of the mouth and tongue. Do not expose yourself to too much sunlight or harsh tanning lights. Sun can damage the lips.
After treatment for lip cancer, ensure you adopt good and diligent dental hygiene to ensure your mouth, teeth, lips and other parts of your oral cavity heal well.