Cancer of the lower lip is not very common. Basically, it is observed in the elderly, who are prone to various neoplasms.
Among all patients with cancer, men 60-70 years old predominate. With age, the body's defenses decrease, resulting in an increased likelihood of malignant neoplasms.
Features of the disease
The ICD 10 code for malignant melanoma of the lower lip is C43.0. In this classification, there is a division of the disease according to the place of occurrence on the lip (surface, red border, etc.). So, the ICD code 10 for cancer of the lower lip C00.1 is the outer surface, the rims, and the code C00.4 is the inner surface, frenum, mucous membrane, buccal surface. The disease is characterized by slow growth and the formation of metastases.
In its structure, a malignant neoplasm is squamous cell carcinoma, for which the very slow growth and formation of metastases is typical. The main danger of the disease is the spread of cancer cells through the lymphatic system.
Initially, metastases affect the sublingual and submandibular lymph nodes. Subsequent cancer progression is accompanied by the formation of metastases in the lungs, liver, and bones. Such processes often end with the death of the patient.
Classification
Cancer of the lower lip can be squamous and basal cell. The latter form is quite rare. In addition, the tumor may be keratinized and keratinized. The first type is characterized by the fact that the neoplasm is growing rapidly. Metastasis can occur even in the initial stages. The keratinized form is characterized by slow growth, ulcers and metastases rarely appear.
In addition, doctors distinguish the following main forms of lip cancer:
- Papillary.
- Ulcerative.
- Warty.
The stages of cancer of the lower lip are determined by the classification indicating the spread of oncology, the appearance of metastases, the presence of affected lymph nodes. At stage 1, the tumor spreads only to the lip tissue, metastasis has not yet occurred. In addition, the lymphatic system is not yet affected.
At stage 2, the tumor may increase in size, but it is still localized only in the tissues of the lip. Lymph nodes are not affected, and there are no metastases. The third stage is characterized by the fact that the tumor is localized only in the tissues of the lip. Lymph nodes are not affected or only one of them is affected, there are no metastases at this stage.
At stage 4, the tumor grows in adjacent tissues, the lymph nodes are not affected, or only one of them is affected. Metastases may or may not exist, it all depends on the characteristics of the disease. Depending on the stage of the malignant process, a treatment technique is selected.
Causes of occurrence
A malignant tumor almost never forms in healthy tissues. There are some factors for the development of cancer, which include various external influences that can lead to disruption of the process of division and the full maturation of epithelial cells. Inflammation and many other changes can provoke the development of the disease. Cancer of the lower lip appears for such reasons:
- Adverse weather conditions.
- Bad habits.
- Damage due to dental diseases, inflammation, injuries.
- The presence of fungal and / or viral infection.
- Congenital defects in lip development.
Tobacco tumors lead to various tumors. When inhaling smoke, not only does the mucosa come into contact with carcinogens, but also the damaging effects of high temperature.
Cancer of the lower lip is less aggressive than the upper, so metastases appear much later. Tumors formed in young people tend to be much more aggressive than in the elderly, despite the fact that they are quite rare.
What does a malignant tumor look like?
Doctors distinguish several types of lip cancer. During the classification, various characteristics of the pathological process are taken into account. The localization of the tumor is taken into account. The neoplasm itself may have a different structure and developmental feature. A tumor may be:
- Squamous keratinized.
- Squamous non-keratinized.
- Warty.
- Papillary.
- Ulcerative.
- Ulcerative infiltrative.
Squamous keratinized cancer is characterized by the fact that it grows very slowly in size and rises above the surface of the lip. This form has a better prognosis, since it rarely gives metastases and does not spread to adjacent tissues for a long time. It is covered with ulcers only in the later stages.
Squamous non-keratinized cancer is characterized by spread to neighboring tissues. The tumor grows inside the lip, is prone to the formation of metastases and is covered with ulcers already in the initial stages.
Warty cancer appears as small warts. The shade of neoplasms can be different, from the natural color of the border of the lips to dark red.
If the lower lip is swollen, then this may be a papillary type of cancer. It is characterized by the presence of a sufficiently dense growth of an irregular shape, which does not cause absolutely any discomfort. Such a neoplasm has no clearly defined boundaries. Around the tumor can be felt compaction of the tissue.
Peptic ulcer cancer is characterized by the fact that the tumor has uneven edges. The adjacent tissues are quite hyperemic. Inside the tumor there is an ulcer, the bottom of which is lined with dead cells. Exudate stands out from it.
Ulcerative infiltrative cancer is characterized by the fact that a large wound with convex uneven edges forms on the lip. Its surface is covered with small sores. In addition, there may be a slight degree of damage to adjacent tissues.
Main symptoms
Usually the very first sign of lip cancer is the formation of a small tightening. It is slightly denser to the touch than adjacent fabrics. When you remove the existing crust under it, a red border of the lower lip is found. After a while, a new crust forms on the seal, which is much larger.
Sometimes the first signs of lip cancer are discomfort in the oral cavity. In addition, you must definitely consult a doctor if you have such symptoms:
- Slight soreness.
- The formation of ulcers, roughness and cracks.
- Discomfort when eating food.
- Itching and burning sensation in the lip area.
At the initial stage of lower lip cancer, the following symptoms are observed:
- Swelling.
- Discomfort or pain while eating.
- The increase in size.
- Blue mucosa.
With a prolonged course of the malignant process, additional signs of intoxication appear, which include:
- General weakness.
- Decreased appetite.
- Temperature rise.
- Headache.
- Irritability.
- Weight loss.
Sometimes part of the tumor undergoes necrotic changes, and the lesion takes the form of ulceration with a small depression in the center. Often secondary infection and the development of purulent processes join in with it. With cancer, the lower lip is quite painful, since there is a significant damage to the tissues.
The duration of the pathological process leads to an even greater spread of the tumor into the lymph nodes (in the last stage). In this case, hoarseness of the voice is observed, the lymph nodes become inflamed, and the mobility of the jaw also significantly deteriorates. In complex and advanced cases, metastases affect significant areas and turn into extensive infiltrates. What the cancer of the lower lip looks like, can be seen in the photos posted in our article. In order to be able to recognize the course of the malignant process in a timely manner, it is important to know the symptoms and signs of the disease.
Diagnostics
It is important to diagnose a malignant tumor on the lip in a timely manner, since this is considered the key to successful treatment and absolutely complete recovery. If the first signs of the disease occur, you should definitely consult an oncologist.
Initially, he conducts a detailed survey to determine when and how minor lip changes appeared, whether treatment was carried out, what the result was. Then the doctor examines the affected area with a magnifier. Mandatory is palpation of the area of growth of the tumor, cheek, jaw, chin and adjacent lymph nodes. After this, a cytological examination or biopsy is prescribed with the subsequent histological analysis of tissues.
Examination of sick people also involves the analysis of urine, blood, X-ray of the lungs, ECG. This is all necessary to exclude the fact that metastases have already formed. An ultrasound of the lymph nodes is performed to clarify the diagnosis. To accurately confirm the presence of a malignant tumor, it is necessary to conduct a histological examination, by which it is possible to determine the type of cancer, its degree of malignancy and prognosis.
Treatment features
If the lower lip is swollen, you need to see a doctor for a diagnosis, as this can be a sign of a malignant neoplasm. The tactics of therapy largely depend on what stage the pathology is at, as well as how far it has spread throughout the body. At the initial stage, the disease is cured almost completely.
Local methods of therapy will be effective only in such cases:
- Only the lower lip tissue is affected.
- The lymph nodes are not affected.
- Metastases have not spread to other organs.
In the presence of metastases, chemotherapy is used in combination with other methods, since only in this way you can get the best possible result.
Operation
Squamous cell carcinoma of the lower lip is successfully treated by surgical excision of tumor tissue and radiotherapy. This greatly increases the likelihood of a full recovery. After the usual excision of the tumor, the chance of a relapse of the disease remains, and irradiation will help to destroy all the remaining affected cells. If it is necessary to restore the shape of the lips and to eliminate the existing cosmetic defect, plastic surgery on the lips is indicated.
The need for such an intervention arises in the case of removal of the lower lip with cancer or excision of a large area. Cryosurgery refers to a newer and more modern method of treatment, which significantly increases the chances of a successful cure and reduces the risk of recurrence of the disease. Initially, the area near the focus of the malignant neoplasm is treated with cold, and then excision of its tissues is performed. For this, various modifications of the scalpel or coagulator are used.
Tissue freezing not only completely destroys all available cancer cells, but also allows the surgeon to perform the operation with much higher accuracy, as it creates a kind of limiting shaft.
Photodynamic therapy is a modern method of treating cancer and is characterized by its safety and high degree of effectiveness. For treatment you will need:
- The drug is a photosensitizer.
- UV source.
- Access of oxygen to tissues.
Before starting the procedure, the patient is given a photosensitizing drug that increases the sensitivity of cancer cells to radiation. After this, spot irradiation with ultraviolet light is carried out.
Such a treatment technique does not provoke side effects and significantly reduces the likelihood of recurrence of tumor formation. The disadvantage is the high cost of the procedure.
Brachytherapy is used in the treatment of relapse of lip cancer. A similar technique involves the introduction of radioactive granules.
Postoperative period
At the end of treatment, the patient should remain in the dispensary registration with an oncologist for several years. It is necessary to regularly undergo examinations by a specialist and conduct an examination for the appearance of relapse of a malignant tumor.
With lower lip cancer, the clinical recommendations mainly relate to the doctor’s observation, as well as compliance with all his prescriptions. During follow-up visits to the specialist, lips are examined, lymph nodes palpation, ultrasound and chest x-ray. The timely detection of metastases and relapses allows for a radical intervention with good results.
Chemotherapy
When a malignant tumor spreads to adjacent tissues and regional lymph nodes, as well as the formation of metastases in other organs, chemotherapy is prescribed, which complements the local treatment. Cytostatics are selected individually. With lip cancer, the following can be used:
- "Bleomycin."
- "Methotrexate."
- Drugs with fluorouracil.
- Preparations with platinum.
Chemotherapy can also be supplemented by a wide variety of radiotherapy techniques. Such treatment is used at any stage of a lip cancer both before and after surgery. Highly active x-ray radiation is often used as a preoperative method of preparing a patient. Ionizing radiation stabilizes growth, and sometimes even reduces the size of the malignant neoplasm.
The adjacent lymph nodes are also irradiated. At the very last stage of the course of the disease, radiation exposure becomes the basis of palliative treatment. It is aimed at alleviating the suffering of the patient and prolonging his life.
Radiation therapy is carried out using a near-focus apparatus. A single dose of radiation is 4-5 Gy, and the total - 60 Gy. The duration and intensity of such a treatment course is determined strictly individually and depends on the size of the affected area.
Folk remedies
Often, patients along with the main therapy use alternative methods of treatment. The most effective means are:
- Beetroot juice.
- St. John's wort broth.
- Burdock ointment.
- Compress of celandine juice and carrots.
Take raw beets, grate, squeeze juice from it and refrigerate for several hours to cool. Drink the medicine on an empty stomach in 100 ml 5 times daily. You can seize the medicine with a piece of bread.
Another effective remedy is St. John's wort broth. Pour 20 g of dry plant with 500 ml of boiling water and put on a small fire. Boil until half of the available liquid has evaporated. Filter and drink 15 ml 3 times daily.
The affected area can be lubricated with burdock ointment. Cook until ready 100 g of the root of the plant, grind and add 0.5 tbsp. vegetable oil. Then put the mixture on fire and boil for another 90 minutes. The finished product is cool and can be used.
In the absence of defects on the lip, you can apply a compress of celandine juice and carrots. Grind this vegetable and squeeze the juice through cheesecloth. Then mix it all in equal proportions and apply to the affected area for 2 hours. Repeat the treatment procedure 3 times a day.
It is worth remembering that folk remedies can be used only in combination with the main methods of therapy and after consulting a doctor.
Forecasts
The favorable prognosis largely depends on the timeliness of the started therapy and the stage of the course of the disease. In the treatment of stage 1-2, the curability of patients is very high, approximately 97-100%. At 4 stages or with relapses, remission can be achieved only in 30% of cases.
Timely detection and initiation of therapy significantly increases the patient's chances of a full recovery. That is why if any diseases of the lips, lips, sores and cracks occur, you should immediately consult a doctor. It must be remembered that the detection of a tumor in the initial stages allows you to completely cure this cancer.
Prevention
It is worth noting that the development of lip cancer is not related to heredity. Therefore, each of us has a chance to prevent the occurrence of the disease. For this purpose, it is necessary to observe several rules:
- Prevent microtrauma of the lips.
- Do not expose to prolonged sun exposure.
- Timely get rid of diseases of the oral genital, teeth, internal organs.
- Follow the rules of oral hygiene.
- To refuse from bad habits.
Compliance with simple rules will help protect you from unpleasant and serious consequences.
Lip cancer can develop in a person of any age, so you should carefully monitor your health. , .