Precancerous changes and types
The tumor usually grows on the changed mucosa. Prolonged exposure to sunlight causes actinic cheilitis: the red border becomes dry, peels, loses its clear border, cracks and crusts appear. Further precancerous conditions are considered leukoplakia - persistent white plaques, and erythroplakia - red velvety spots, which are more dangerous than white ones. The cancer itself most often grows in the form of an ulcer with dense, roll-like edges or in the form of a growth resembling a wart. More than nine out of ten cases are squamous cell carcinoma, often with a slow progression.
- Actinic cheilitis as background
- Leukoplakia - white plaques
- Erythroplakia - red spots, more dangerous
- Ulcerative form with dense edges
- Overgrowth like a wart
- Squamous cell carcinoma predominates
Causes and risk factors
The main factor is the dose of ultraviolet radiation accumulated over the years, so the disease is more common in men who work outdoors: in agriculture, construction, and transport. Smoking, especially pipes and roll-your-own cigarettes, adds both thermal and chemical damage. Chronic trauma to the lip from a sharp tooth edge or poorly fitting prosthesis, lack of oral hygiene, and consumption of strong alcohol are important. Light skin, which is prone to burns, increases the risk. Decreased immunity also plays a role, including after organ transplantation.
- Long-term solar exposure
- Smoking, especially pipes
- Chronic injury from a sharp tooth or denture
- Strong alcohol
- Light sensitive skin
- Reduced immunity
- Poor oral hygiene
Symptoms
Early manifestations are so minor that people treat them with ointments and balms for months. Usually this is a small area of compaction, a crust that falls off and forms again, or a crack in the same place. An ulcer with a dense bottom and raised edges gradually forms, it begins to bleed when eating and talking, and sometimes an unpleasant odor appears. Pain comes late, and its absence is often deceiving. A sign of spread is the appearance of a dense, painless lymph node under the lower jaw or on the neck.
- Non-healing ulcer or crust on the lip
- Seal in the thickness of the lip
- Bleeding when eating or talking
- White or red spots on the border
- No pain in the early stages
- Numbness when spreading to nerves
- Dense lymph node in the neck
Diagnostics
Examination and palpation of the lip, oral cavity and lymph nodes of the neck is performed by a dentist or oncologist. The decisive study is a biopsy: a fragment of the formation is taken and examined under a microscope, since only histology distinguishes cancer from inflammation, herpes and benign changes. Upon confirmation, the prevalence is assessed: an ultrasound of the lymph nodes of the neck is performed, if necessary, a fine-needle puncture of a suspicious node; in case of deep germination and large tumors, a CT or MRI is performed with an assessment of the jaw bones. The entire oral mucosa is also examined so as not to miss a second lesion.
- Inspection and palpation of the lip and lymph nodes
- Biopsy with histological examination
- Ultrasound of the lymph nodes of the neck
- Fine needle puncture of a suspicious node
- CT or MRI for common forms
- Examination of the entire oral mucosa
Treatment and prevention
The main method in the early stages is surgical removal of the tumor within healthy tissues with simultaneous plastic surgery, which allows preserving the shape of the lip and the function of the mouth. For small tumors, radiation therapy provides comparable results; the choice depends on the location, size and preference of the patient after discussion with the doctor. If the lymph nodes are affected, surgery is performed on the neck, and for widespread tumors, treatment is combined. Prevention is simple: sun protection, stopping smoking, treating cheilitis and eliminating traumatic teeth and dentures.
- Surgical removal with lipplasty
- Radiation therapy for small tumors
- Surgery on the lymph nodes of the neck if they are affected
- Combined treatment for common forms
- Hygienic lipstick with UV protection
- A hat with a brim when working in the sun
- Quitting smoking and treating precancerous changes
