Lip and Mouth Cancer
Lip and mouth cancer, also called oral cancer, can occur in the lips, the lining of the lips and cheeks, the front two thirds of the tongue, the gums, the small area behind the wisdom teeth, the bony roof of the mouth, and the floor of the mouth under the tongue or the back of the mouth.
People typically first notice a problem because of sores on the lip or mouth that don’t heal, lumps or thickening on the lips or gums, white and/or red patches or bleeding, pain or numbness of the lip or mouth. There are also a number of other symptoms associated with this type of cancer. Remember that the symptoms you experience might also be caused by other medical conditions so it’s important for you to consult a physician to confirm a diagnosis.
Oral cancer typically spreads first by entering the lymphatic vessels in the area where the cancer is growing. From there, the cancer cells travel to the lymph nodes in the neck where they may continue to spread through the lymphatic vessels or blood vessels to distant sites in the body such as the lung or spine. When that happens, the cancer continues to grow in the new location as oral cancer rather than turning into a cancer of the lung or spine.
The most common tumor to develop in the lips and mouth is called squamous cell carcinoma. This type of tumor develops in the flat cells that line the moist surfaces of the mouth, nose and throat.
It’s normal for you to wonder how you got oral cancer. Although we still don’t have all the answers, we do know that there are risk factors associated with people developing this cancer, especially sun exposure, alcohol, smoking, being over 50, being male, diet, and ongoing infection of the oral cavity by HPV, the human papilloma virus. Remember that there is no single cause for developing this type of cancer.
Screening and Diagnosis
You may need to undergo a number of tests for the screening and diagnosis, which will help your team to assess the stage, or severity of the cancer. Your head and neck specialist will first perform a physical examination to look for signs and symptoms of cancer, and then may order one or more of the most commonly used tests such biopsy, endoscopy, and x-rays.
Learn about some of the other tests commonly used for head and neck cancers
For oral cancer, the guiding principle is to choose a treatment approach that will lead to the best outcome in terms of preserving speech, swallowing and facial appearance.
For small lip and mouth cancers that have not spread to the neck lymph nodes, the frontline treatment is surgery. In such cases, surgery effectively removes small tumors without causing significant problems with chewing, swallowing and speaking. Radiation is generally not used to treat small lip and mouth tumors because it causes undesirable side effects such as loss of taste and dry mouth. These side effects are particularly an issue when radiation is given to the tongue.
When lip and mouth tumors are large or when multiple lymph nodes are also involved, the addition of radiation and/or chemotherapy after surgery ensures the complete removal of the tumor and helps to prevent its further spread. There are many surgical techniques available for reconstructing the lip and mouth area and these help to restore the changes in appearance that may result from the extensive surgery to the affected area. For the most advanced cases of lip and mouth cancer where surgery would be too debilitating, chemotherapy and/or radiation are used as the sole treatment.
If lip and mouth cancer returns, patients are offered a therapy other than the primary treatment they received. For example, if patients had surgery initially, then they may be offered radiation and/or chemotherapy, or surgery combined with radiation and/or chemotherapy. Patients may also be interested in participating in clinical trials that are investigating new approaches for treating recurrent lip and mouth cancer.
Early and Late Stages of Lip and Mouth Cancer
Surgical Complications of Lip and Mouth Cancer
Preparing for Your Surgery
Follow-up care for oral cancer is critical and you will need to see a doctor on a regular basis. You may also need ongoing therapy for speaking and swallowing problems.
Many members of the multidisciplinary treatment team will work with you through this challenging process, and can offer continuing care and guidance about the services and resources that may be of assistance during your recovery or palliative care.