Lip cancer is the most common form of oral cancer in the world and belongs to the head and neck cancer group. This carcinoma includes malignant lesions of the epithelium of the red border of the mouth, where under the influence of external factors normal cells can turn into abnormal cells, and later – into cancer cells. Most cancers have a well-defined morphology and prognosis.
In more than 90% of cases, lip cancer is represented by squamous cell carcinoma, which is the most common type of cell carcinoma in this localization. Basal cell carcinoma is much less common, mainly in patients with fair skin, light skin or dark skin, depending on the intensity of solar exposure. The lower lip is most commonly affected, while upper lip tumors usually have a more aggressive course [1]. In most cases, malignant transformation begins with squamous cells that undergo chronic damage and accumulation of mutations.
Epidemiology and Risk Factors of Lip Cancer
Compared to other forms of oral cavity cancer, lip cancer has a clear analytical epidemiology. Risk factors include long-term exposure to ultraviolet light, smoking, occupational factors, immunosuppression, viral infections, particularly human papillomavirus, and socioeconomic conditions.
The process of developing lip cancer is usually long and multi-stage. Under the influence of risk factors, oral cells gradually transform into tumor cells, which form a localized tumor, and over time can spread to the structures of the mouth, oral cavity, and the head and neck region. In cases of advanced lip cancers, there is a high risk that the cancer has spread to the lymph nodes.
The squamous cell variant of oral carcinoma is most common because the red border of the oral cavity is covered by a multilayer squamous epithelium that undergoes chronic UV irradiation and irritation; it is this epithelium that most often passes through dysplasia (actinic cheilitis) into squamous cell carcinoma, while the glandular epithelium is almost absent here.
Why Treatment Choice is Critical in Lip Cancer?
Head and neck cancer treatment requires an individualized approach, taking into account the location of the tumor, the stage of the disease, and the need to preserve the patient's functions and quality of life. The choice of treatment plan in lip cancer treatment is critical. Standard treatment, especially with larger lip cancers or larger tumors, can lead to significant tissue loss, speech, facial expressions and eating disorders. That is why treatment options should take into account not only the need to kill cancer cells and destroy cancer cells, but also the preservation of the function and appearance of the face.
The modern approach to cancer treatment in lip cancer is focused on the organ preservation lip cancer, especially if the disease is diagnosed at early stages. Even with stage III and stage IV, alternatives to radical surgery are possible. Lip cancer treated in the early stages has a high chance of complete recovery with preservation of function and appearance.
Standard Treatment Approaches for Lip Cancer
Surgery for Lip Carcinoma
Lip cancer surgery is the most common treatment in localized forms. Surgical removal of the tumor can be accompanied by reconstructive surgery or plastic surgery, especially if a significant volume of the mouth is affected [2].
Radiation therapy for Lip Carcinoma
Radiation therapy (or radiotherapy), including internal radiation, are often used in small lip cancers or as part of combination treatment.
Chemotherapy and chemoradiotherapy for Lip Carcinoma
Chemotherapy and chemoradiotherapy are used primarily in stage III and stage IV, or if the cancer has spread outside the primary tumor. Chemoradiotherapy is considered in advanced forms of oral carcinoma as part of a multimodal approach to increase local disease control [3].
Innovative Treatment Options for Lip Carcinoma
The limitations of standard treatment contributed to the development of new treatments and innovative treatment for lip cancer, which allow to achieve local control without significant damage to the tissue and structures of the mouth.
Dendritic Cell Therapy for Lip Carcinoma
Dendritic cell therapy lip cancer – is an immunotherapeutic approach aimed at activating the patient's own immune response against the tumor. The discovery of Dendritic cell therapy was recognized with the Nobel Prize in Physiology or Medicine, emphasizing the fundamental importance of this area for modern oncology. The method is based on the use of dendritic cells that train the immune system to recognize and destroy tumor cells.
Dendritic cell therapy for lip cancer activates the immune system, helping to destroy remaining tumor cells after local treatment. Potential benefits of the approach include minimal effects on facial anatomy, speech and food retention, and low toxicity compared to systemic chemotherapy. At the same time, the method remains innovative and is used mainly in specialized centers in Germany [4].
Regional chemotherapy for Lip Carcinoma
Regional chemistry for lip cancer – is a localized treatment method in which anticancer drugs are injected directly into the vascular pool of the affected area, ensuring a high concentration of drugs in the tumor with minimal systemic exposure.
This approach may be used in locally advanced or recurrent forms of oral tumors, especially when standard surgery or radiation therapy is associated with a high risk of functional and aesthetic loss. The main benefits are reduced systemic toxicity, potential reduction in tumor volume, and the creation of conditions for more gentle follow-up treatment or organ-sparing strategies. During regional chemo, the chemotherapy drug is injected through a catheter into the feeding arteries of the mouth, which allows a high local dose to be delivered without significant entry into the systemic bloodstream. As a result, tumor cells are directly cytotoxic, while systemic side effects are significantly reduced. Regional chemotherapy lip cancer reduces systemic toxicity and is suitable for patients with advanced lip cancers [5].
Electrochemotherapy (ECT) for Lip Carcinoma
Electrochemotherapy for lip cancer – is a local treatment method that combines the administration of a chemotherapy drug with short electrical impulses that temporarily increase the permeability of tumor cell membranes (electroporation).
In the treatment of oral cancer, ECT lip cancer is used mainly for localized, recurrent or superficial lesions, when it is important to avoid surgical deformation and preserve the function of the mouth. The method allows to achieve high local efficiency with minimal damage to healthy tissues, maintaining speech, food intake and acceptable aesthetic results.
ECT is seen as an organ-sparing alternative or adjunct to standard therapies, especially in patients with limited therapeutic options [6].
Organ Preservation, Aesthetics, and Quality of Life in Lip Carcinoma
The table below demonstrates how different carcinoma treatment methods affect not only oncological control, but also the preservation of the patient's mouth shape, speech, facial expressions, and psychological state, which is critically important when choosing the optimal therapeutic strategy.
| Type of treatment | Preserving the shape of the lip | Speech | Facial expression | Psychological state |
|---|---|---|---|---|
| Surgery | Often impaired; possible deformities, scarring, need for reconstruction | May worsen due to tissue or muscle loss | Often impaired due to muscle and nerve damage | Higher risk of distress due to visible defects and change in appearance |
| Radiation therapy | Fibrosis and atrophy are possible | Usually preserved, dryness and discomfort may occur | Mostly preserved | Moderate impact; fear of late side effects |
| Chemotherapy | Not directly affected | Not impaired | Not impaired | Often worsens due to systemic toxicity and fatigue |
| Chemoradiotherapy | Better than after surgery, but worse than local methods | May be impaired due to mucositis and fibrosis | Partially preserved | Significant impact due to high treatment burden |
| Dendritic cell therapy | Completely preserved | Not impaired | Not impaired | Least negative impact, high patient acceptability |
| Regional chemotherapy | Mostly preserved | Preserved | Preserved | Less distress due to local treatment |
| Electrochemotherapy | Maximally preserved | Preserved | Preserved | Better quality of life, minimal psychological pressure |
Treatment Strategies for Recurrent or Advanced Lip Carcinoma
Treatment of recurrent or advanced lip cancers requires a combined and individualized approach, taking into account the localization of the lesion, the involvement of bones, nerves and lymph nodes, as well as previously carried out treatment.
In the later stages the basis of therapy is usually a combination of surgery and radiation therapy. The scope of the operation is determined by the size and location of the tumor and the need for reconstruction; treatment of both sides of the neck is indicated in selected patients. Radiation therapy may be administered as EBRT (external beam radiation therapy) with or without brachytherapy, and in some cases superfractionated RT (within clinical evaluation) is considered.
For metastatic and recurrent forms, the role of immunotherapy is increasing, while standard chemotherapy, despite possible responses, does not show a convincing improvement in survival. Due to the limited results of repeated radical interventions, innovative techniques (dendritic cell therapy, regional chemotherapy, ECT) are considered as alternatives to crippling surgery, with the aim of preserving the function, appearance and quality of life of the patient.
The table below allows you to compare the approximate cost of different treatments for this type of carcinoma.
| Treatment type | Cost Germany | Cost USA | Cost GB | Cost Australia |
|---|---|---|---|---|
| Surgery | €25,000 - €45,000 | €65,000 - €85,000 | €35,000 - €55,000 | €30,000 - €70,000 |
| Chemotherapy | €80,000 - €150,000 full course | €100,000 - €180,000 full course | €90,000 - €165,000 full course | €45,000 - €120,000 |
| Radiotherapy | €28,000 - €42,000 | €40,000 - €80,000 | €35,000 - €65,000 | €25,000 - €50,000 |
| DC therapy | €20,000 - €38,000 | €40,000 - €100,000 | not available | not available |
| Regional chemotherapy | €45,000 per session | €37,000 - €150,000 | €30,000 - €118,000 | €30,000 - €80,000 |
| Electrochemotherapy | €7,500 - €12,000 per session | €40,000 - €100,000 | €25,000 - €45,000 | not available |
History of Patient with Lip Carcinoma
Stories of patients with oral carcinoma highlight the importance of an individualized and organ-sparing approach, especially in common forms of the disease. A 52-year-old patient was diagnosed with locally advanced squamous cell carcinoma of the lower lip with regional lymph node involvement (cT3N1M0, stage IVA) accompanied by pain, speech impairment and difficulty eating. The patient refused standard radical surgical treatment, noting: "I was not ready to accept the loss of lip shape and normal speech".
As an organ-sparing alternative, short-term regional intra-arterial chemotherapy was applied, with selective administration of drugs into the tumour feeding arteries and chemofiltration to reduce systemic toxicity. After the treatment, pronounced clinical and radiological regression of the tumor, reduction of pain syndrome and restoration of speech and eating without clinically significant side effects were recorded.
At the observation stage, the patient is in stable remission with a preserved lip shape and a good quality of life, summarizing the result of the treatment with the words: "I returned to a normal life without pain and limitations".
A Medical Journey: Every Step of the Way With Booking Health
Finding the best treatment strategy for your clinical situation is a challenging task. Being already exhausted from multiple treatment sessions, having consulted numerous specialists, and having tried various therapeutic interventions, you may be lost in all the information given by the doctors. In such a situation, it is easy to choose a first-hand option or to follow standardized therapeutic protocols with a long list of adverse effects instead of selecting highly specialized innovative treatment options.
To make an informed choice and get a personalized cancer management plan, which will be tailored to your specific clinical situation, consult medical experts at Booking Health. Being at the forefront of offering the latest medical innovations for already 12 years, Booking Health possesses solid expertise in creating complex cancer management programs in each case. As a reputable company, Booking Health offers personalized lip carcinoma with direct clinic booking and full support at every stage, from organizational processes to assistance during treatment. We provide:
- Assessment and analysis of medical reports
- Development of the medical care program
- Selection of a suitable treatment location
- Preparation of medical documents and forwarding to a suitable clinic
- Preparatory consultations with clinicians for the development of medical care programs
- Expert advice during the hospital stay
- Follow-up care after the patient returns to their native country after completing the medical care program
- Taking care of formalities as part of the preparation for the medical care program
- Coordination and organization of the patient's stay in a foreign country
- Assistance with visas and tickets.
- A personal coordinator and interpreter with 24/7 support
- Transparent budgeting with no hidden costs
Health is an invaluable aspect of our lives. Delegating management of something so fragile yet precious should be done only to experts with proven experience and a reputation. Booking Health is a trustworthy partner who assists you on the way of pursuing stronger health and a better quality of life. Contact our medical consultant to learn more about the possibilities of personalized treatment with innovative methods for lip carcinoma with leading specialists in this field.
Cancer Treatment Abroad: Patient Experiences with Booking Health
Frequently Asked Questions About Lip Cancer
Send request for treatmentThe first stages of lip cancer usually correspond to stages I-II and are characterized by a small localized lesion without metastases; it is at this stage that early-stage lip cancer treatment is most effective and organ-preserving.
Survival for this type of carcinoma in the early stages is high and can exceed 90%, especially with timely treatment and the use of modern therapies aimed at preserving lip function.
In the case of progression, this type of cancer most often spreads to the regional lymph nodes of the neck; distant metastases are much less common and are usually characteristic of the later stages.
The best treatment for lip carcinoma is determined by the stage of the disease, the localization of the tumor and the expected functional outcome and may include surgery, radiation therapy or organ-preserving treatment using innovative methods.
Yes, in many cases lip cancer can be treated without radical surgery thanks to alternatives to surgery, in particular local and immune-oriented treatment methods.
Dendritic cell therapy for oral cancer shows promising results as part of modern therapies, especially in patients with recurrent or advanced forms, providing immune control of the tumor with minimal impact on the tissues.
Regional chemotherapy for oral cancer is a method of local administration of chemotherapy drugs into the vascular pool of the tumor, which allows to achieve high treatment efficiency with reduced systemic toxicity.
Electrochemotherapy lip cancer, or ECT, combines the administration of chemotherapy drugs with electrical impulses that increase the permeability of cell membranes, enhancing the local antitumor effect.
Yes, innovative treatments can be used as early-stage cancer treatment, especially when organ-preserving treatment and preservation of face anatomy are the priority.
The choice of treatment method directly affects the facial appearance, speech, and quality of life; organ-preserving and innovative approaches usually provide better functional and psychological outcomes.
Choose treatment abroad and you will for sure get the best results!
Authors:
This article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova, and Dr. Daria Sukhoruchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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Sources:
[1] J G de Visscher, I van der Waal. Etiology of cancer of the lip. A review. Int J Oral Maxillofac Surg. 1998 Jun;27(3):199-203. doi: 10.1016/s0901-5027(98)80010-6. [DOI] [PubMed]
[2] D Franceschi, R Gupta, R H Spiro, J P Shah. Improved survival in the treatment of squamous carcinoma of the oral tongue. Am J Surg. 1993 Oct;166(4):360-5. doi: 10.1016/s0002-9610(05)80333-2. [DOI] [PubMed]
[3] T J Ervin, J R Clark, R R Weichselbaum, B G Fallon et al. An analysis of induction and adjuvant chemotherapy in the multidisciplinary treatment of squamous-cell carcinoma of the head and neck. J Clin Oncol. 1987 Jan;5(1):10-20. doi: 10.1200/JCO.1987.5.1.10. [DOI] [PubMed]
[4] Vidya Mallipattana Anne Gowda, T Smitha. The dendritic cell tool for oral cancer treatment. J Oral Maxillofac Pathol. 2019 Sep-Dec;23(3):326–329. doi: 10.4103/jomfp.JOMFP_325_19. [DOI] [PMC free article]
[5] Karl R Aigner, Emir Selak, Kornelia Aigner. Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life. J Cancer Res Clin Oncol. 2018 Oct 31;145(1):261–268. doi: 10.1007/s00432-018-2784-4. [DOI] [PMC free article]
[6] M. Gargiulo, J.M. Serra Mestre, A. Cortese et al. Long term effectiveness of electrochemotherapy for the treatment of lower lip squamous cell carcinoma. Journal of Cranio-Maxillofacial Surgery Volume 46, Issue 11, November 2018, Pages 1968-1974. [DOI]
Read:
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