Skin cancers on the lips are also considered oral, or mouth, cancers. They can appear anywhere on the upper or lower lips but are more likely to be found on the bottom lip due to more regular sun exposure.
The lips can be a site for squamous cell carcinoma, where they develop in the thin, flat squamous cells that line the lips, or basal cell carcinomas. They begin when cells develop mutations in their DNA. These abnormal cells grow out of control, which results in tumours on the lips.
In rarer cases, melanoma, sarcoma and lymphoma can also develop on the lips.
How common is skin cancer on the lips?
Although cancer of the lips has been found to be the most common type of oral cancer, its occurrence is generally considered quite rare. According to the Cancer Council, just a few hundred cases are diagnosed each year in Australia.
Lip cancers don't receive as much attention as other types of skin cancer, so it is important to understand what causes them and what measures can be taken to minimise the risk of developing them later in life.
Understand what causes lip skin cancer
Like most skin cancers, lip skin cancers are often caused by spending prolonged periods in sunlight, exposing the skin to damaging ultraviolet (UV) rays.
People who use tobacco products and those who regularly consume excessive amounts of alcohol are more likely to develop these types of cancers.
While lip cancers can affect both men and women, they are more commonly found in males with light skin over the age of 50 who regularly spend time outside.
Important lip skin cancer risk factors to be aware of
Anyone can get skin cancer on their lips, but factors that can increase your risk include:
- Exposure to UV rays from tanning beds
- Human papillomavirus (HPV) infection, a sexually transmitted virus that can cause bowen's disease, or squamous cell carcinoma in situ. Bowen's disease is a very early form of skin cancer that should not be ignored.
- Men are more at risk than women. However, studies have failed to conclude why this is the case. Some researchers have suggested it could be linked to alcohol or tobacco use, while others suggest it could also be linked to the use of lip balm or lip gloss.
- Having a family history of mouth cancers
- Your age can also play a role, with adults aged over 45 at higher risk
- Poor oral hygiene and gum disease
- Cenratin genetic conditions
- Epstein-barr virus (EBV)
- Those with a weakened immune system
Know what signs of lip cancer to look for
If something doesn't seem right, don't leave things to chance. Lip cancers are almost always curable when they are detected early. As well as seeing a professional for regular skin cancer screenings, you should check your lips regularly for changes in the appearance of the skin to assist with early detection.
The early stages of lip cancer can appear like a flat or slightly raised patch of discolouration. Sometimes it can look similar to scar tissue. In those with light-coloured skin, it may look reddish in colour. In people with darker-coloured skin, it may appear grey or dark brown.
Lip cancer lesions can also look similar to cold sores when they first appear. However, instead of disappearing within a few days, cancerous lesions will not clear up on their own.
Common signs and symptoms to look for
- A sore, lump, blister or ulcer on the lip that doesn’t disappear
- A discoloured patch of skin on the lips that could be red, white or dark, depending on your skin colour
- Bleeding on the lips
- Pain, tingling, numbness or loss of sensation of the lips or skin around the mouth or head
- Swelling of the jaw or face, throat or tongue or nose
- Growths or masses in the neck or swollen lymph nodes
Important lip conditions to be aware of
Sometimes called smoker's keratosis, Leukoplakia affects the oral mucosal tissue. It appears as thick, white patches inside the mouth and it can be a sign of precancerous changes in the mouth. Oral cancers, including those on the lips, often form near these unsightly patches.
Actinic (solar) keratosis
Actinic keratosis are scaly patches found on the skin that are caused by too much exposure to the sun. They can be an early sign of cancer so it is best to have them seen to as soon as possible. One form of actinic keratosis specific to the lips is actinic cheilitis, also known as farmer’s lip or sailor’s lip. It can make your lips appear rough, cracked, chapped dry and flaky.
One uncommon type of cancer that also affects the mouth and lips is verrucous carcinoma, which causes cauliflower-like lesions on the skin and can be extremely disfiguring.
How is skin cancer on the lips diagnosed and treated?
Lip cancer treatment varies depending on the stage and size of the cancer. Your doctor is the best person to give advice and answer any questions while suggesting the best course of action following a diagnosis.
How lip skin cancer is diagnosed
- A physical skin examination is usually the first step in ascertaining if you have cancer on your lips. Your doctor will also examine your mouth, face and neck to check for signs of cancer.
- Exfoliative cytology may be performed. This is where a small scraping of the suspected tumor is taken and examined under a microscope.
- A biopsy or sample of the affected tissue is removed and sent to a pathology lab for analysis.
- As it is possible to simultaneously develop cancer in more than one area of your body, other tests such as a fine needle aspiration biopsy or complete blood count.
- Imaging tests such as a CT scan, PET scan, MRI or X-rays may be used to determine the spread and stage of cancer cells or to determine if cancer has spread beyond the lip.
- If it is suspected that cancer has spread beyond your lip, your doctor may refer you for an endoscopy. This is where flexible, tube-like instruments are used to examine your throat, esophagus, windpipe etc. It is usually performed under general anaesthesia.
How lip skin cancer is treated
- Treatment for lip cancer usually involves surgery. Mohs surgery involves removing thin layers of skin one at a time. However, more invasive surgery may be necessary to remove the cancer and, following this, reconstruction surgery or procedures may be necessary.
- Radiation therapy may be used by itself or in combination with surgery to eliminate cancer cells and prevent the recurrence of cancer.
- Chemotherapy may be used in conjunction with radiation if your lip cancer has spread to other parts of your body.
- Immunotherapy can sometimes be necessary when the cancer has advanced to other parts of your body and other treatments are not an option.
Take measures to prevent cancer of the lips
As the saying goes, prevention is better than cure and there are plenty of ways in which you can protect yourself from lip cancer.
- Consider your lifestyle factors. Limit your alcohol consumption and avoid tobacco use altogether. Don't smoke cigarettes or use other tobacco products such as cigars, pipes and chewing tobacco
- Limit the amount of time spent in the sun
- Use sunscreen and lip balm with SPF protection
- Avoid using tanning beds
- Undertake regular skin checks at a skin cancer clinic or with your primary physician
If you suspect something isn't right
As with all cancers, early detection is key. The removal of smaller cancers will likely have minimal impact on your appearance, but a squamous cell carcinoma on your lips could also be permanently disfiguring. If you suspect something isn't quite right on your lips, or you fall into one of the above risk categories, it is best to book an appointment for a skin check today.