Lip cancer
Cancer of the lip is really a skin cancer of the sun-exposed lower lip, usually found early because it can be seen. A small operation or radiotherapy cures most people, and reconstruction keeps the mouth working.
Overview
Lip cancer is squamous cell carcinoma of the vermilion, the red part of the lip, and the great majority arise on the lower lip, which faces the sun, in fair-skinned men who work outdoors or smoke, often from a precursor patch of actinic cheilitis. Upper lip tumours are more often basal cell carcinomas spreading from the skin. Because the eighth edition of the staging system moved vermilion lip cancer into the skin cancer chapter, only cancer of the inner mucosal lip is now staged with the oral cavity, though lip cancer is still treated by head and neck teams.
Most tumours are small when found and are cured by wedge excision, closed directly or, for larger defects, with Abbe, Estlander or Karapandzic flaps that keep the mouth competent and mobile. Radiotherapy, by external beam or brachytherapy, is an equally effective alternative, chosen for tumours at the commissure or in patients unfit for surgery. Nodal spread is uncommon in small tumours, so the neck is observed or staged with sentinel node biopsy and dissected only when nodes are found or the primary is large, thick or has perineural invasion.
Advanced tumours invading the jaw or with nodal spread are treated with resection, neck dissection and postoperative radiotherapy, with cisplatin for extranodal extension or positive margins, and unresectable or metastatic disease is treated as cutaneous squamous cell carcinoma with cemiplimab or as head and neck squamous cell carcinoma with pembrolizumab. Sun protection and smoking cessation prevent most cases, and treating actinic cheilitis prevents progression.
State of the art
- Local flap techniques a century old still give the best functional results.
- Radiotherapy and surgery cure similar proportions, so the choice rests on function and cosmesis.
- Immunotherapy for cutaneous squamous cell carcinoma now covers the rare advanced lip cancer.
Red cards
From the labels and guidelines behind the standard of care. Your team's thresholds win.- Emergency services nowHypophysitis or adrenal crisis
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
- Emergency services nowBleeding or bruising
Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
- Check before combiningFood and drink: Pembrolizumab
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
- Check before combiningKidneys: Cisplatin
Dose reduce or avoid for CrCl below 60 (carboplatin is the alternative).
- Good to knowImmune-related endocrinopathies (thyroiditis, hypophysitis)
Immunotherapy can attack hormone-producing glands: most often the thyroid (usually ending in an under-active thyroid needing lifelong tablets), and less often the pituitary (hypophysitis) or adrenal glands, which can be life-threatening if missed.
See all on the product pages:CemiplimabCisplatinPembrolizumab·Printable cards in the navigator
Anatomy and lymph node drainage
- Oral cavity and tongue
- Oropharynx: tonsil, base of tongue (HPV)
- Nasopharynx (EBV)
- Larynx and hypopharynx
- Parotid and other salivary glands
- Thyroid
- Nodes: level I (submandibular)
- Nodes: level II (upper jugular)
- Nodes: level III-IV (jugular)
- Nodes: level V (posterior)
- Nodes: level VI (central, thyroid)
- Nodes: retropharyngeal (nasopharynx)
Site decides cause and behaviour: HPV drives oropharyngeal cancer, EBV drives nasopharyngeal cancer, tobacco drives oral and laryngeal cancer; all drain into the neck node levels that surgeons and radiotherapists map.
- Oral cavity and tongueLower lip squamous cell carcinoma (sun and tobacco related) · Mucosal lip cancer staged with the oral cavity
- Oropharynx: tonsil, base of tongue (HPV)
- Nasopharynx (EBV)
- Larynx and hypopharynx
- Parotid and other salivary glands
- Thyroid
- level I (submandibular)
- level II (upper jugular)
- level III-IV (jugular)
- level V (posterior)
- level VI (central, thyroid)
- retropharyngeal (nasopharynx)
Same organ: Oropharyngeal cancer (tonsil and base of tongue), Laryngeal and hypopharyngeal cancer, Oral cavity cancer (mouth and tongue), Head and neck squamous cell carcinoma, Nasopharyngeal carcinoma, Salivary gland cancers, Papillary thyroid cancer, Follicular thyroid cancer, Medullary thyroid cancer, Anaplastic thyroid cancer, Thyroid cancer, Nasal cavity and paranasal sinus cancers (including esthesioneuroblastoma), NUT carcinoma (midline carcinoma with NUTM1 rearrangement), Parathyroid carcinoma, Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4), HPV-positive oropharyngeal cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), Recurrent or metastatic head and neck squamous cell carcinoma, Hypopharyngeal cancer, Adenoid cystic carcinoma, Salivary duct carcinoma, Mucoepidermoid carcinoma, Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India)
Mostly squamous cell carcinoma of the lower lip in fair-skinned outdoor workers and smokers; it is caught early because it is visible, and excision or radiotherapy cures the great majority.
Cases by country
No country-level case numbers. This cancer is not mapped to a GLOBOCAN site.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Wedge or V excision with local flap reconstruction, or radiotherapy (external beam or brachytherapy) for commissure tumours or unfit patients.
Resection with flap reconstruction, sentinel node biopsy or neck dissection, and postoperative radiotherapy; cisplatin for extranodal extension or positive margins.
Cemiplimab as for cutaneous squamous cell carcinoma, or pembrolizumab-based treatment as for head and neck squamous cell carcinoma.
Sun protection of the lips, smoking cessation, and treatment of actinic cheilitis.
Subtypes & biomarkers
top- Lower lip squamous cell carcinoma (sun and tobacco related)
- Upper lip cancer (often basal cell carcinoma)
- Commissure (corner of the mouth) cancer
- Mucosal lip cancer staged with the oral cavity
- Actinic cheilitis (precursor)
- Tumour thickness and depth
- Perineural invasion
- Margin status
- Immunosuppression (transplant recipients)
- PD-L1 (advanced disease)
How often this target appears
- 1898Abbe describes the cross-lip flap
- 1974Karapandzic describes the neurovascular flap that keeps the mouth working
- 2017Vermilion lip cancer moves to the skin cancer staging chapter (AJCC 8th edition)
Dated changes read from the records linked to this cancer: approvals, regulatory steps, reported trials, guideline versions and milestones. Newest first; no date is inferred.
All 5 changes by month →- 2026-09-17This recordLip cancerFacts on this page last checked
When this page itself was last checked or edited.
- 2019Trial resultKEYNOTE-048KEYNOTE-048 reported
OS 14.
- 2017MilestoneLip cancerVermilion lip cancer moves to the skin cancer staging chapter (AJCC 8th edition)
A milestone in how this cancer is treated.
- 1974MilestoneLip cancerKarapandzic describes the neurovascular flap that keeps the mouth working
A milestone in how this cancer is treated.
- 1898MilestoneLip cancerAbbe describes the cross-lip flap
A milestone in how this cancer is treated.
What is in development for Lip cancer, drawn from the whole corpus: 0 items. Drugs are grouped by the most advanced trial phase they have reached anywhere; approved treatments sit under standard of care. Technologies are the methods being tested for this cancer, trials are the studies recorded here, and ideas are proposals not yet in a trial.
Nothing recorded in development for this cancer yet.
Open problems and what is being done
Lip cancer in outdoor workers in sunny countries is under-recognised and under-protected.
Function and appearance after resection of more than half the lip.
Whether sentinel node biopsy should be routine for thicker tumours.
Trials
topTrials recruiting now
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
Landmark trials
Expert centres
topExpert centres
Baltimore · cancer center | United States | 0 | 2,955 | 41,449 | #10 | ||
Milan · cancer center | Italy | none recorded | 0 | 1,246 | 21,746 | #11 | |
Bethesda, MD · government | United States | none recorded | 0 | 2,905 | 47,715 | - | |
Utrecht · cancer center | Netherlands | none recorded | 0 | 1,422 | 20,323 | - | |
Tianjin · cancer center | China | none recorded | 0 | 1,219 | 11,455 | - | |
Hangzhou · cancer center | China | none recorded | 0 | 1,219 | 17,635 | - | |
Rozzano (Milan) · hospital | Italy | none recorded | 0 | 1,031 | 10,720 | - | |
Changsha · cancer center | China | none recorded | 0 | 930 | 14,477 | - | |
Jinan · cancer center | China | none recorded | 0 | 920 | 7,804 | - | |
Dresden · cancer center | Germany | none recorded | 0 | 728 | 7,984 | - | |
| United Kingdom | none recorded | 0 | 693 | 7,168 | - | ||
Chennai · cancer center | India | none recorded | 0 | 691 | 13,919 | - | |
Aarhus · hospital | Denmark | none recorded | 0 | 624 | 4,497 | - | |
Freiburg im Breisgau · cancer center | Germany | none recorded | 0 | 549 | 5,261 | - | |
Lausanne · hospital | Switzerland | none recorded | 0 | 509 | 9,176 | - |
These are the things we can measure; they are not a ranking of quality. Each column is a field on the institution record or a count over what OnCo has linked; a centre that treats many patients with Lip cancer but is thinly recorded here will look small.
Not known: OnCo holds no case-volume or outcome figures for centres, so none are shown. Where a national audit or registry publishes them, the centre's page links to it. Default order: Newsweek rank, then trials for this cancer, then research output.
Questions to ask
topQuestions to ask your oncologist about Lip cancer
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Why: Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example Tumour thickness and depth, Perineural invasion, Margin status, Immunosuppression, PD-L1), and what were the results?Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Why: Recognised subtypes for this cancer include Lower lip squamous cell carcinoma, Upper lip cancer, Commissurecancer.
- Is germline (inherited) genetic testing recommended for me or my family?Why: Inherited variants can change treatment and matter for relatives.
Early disease
- For my situation (early disease), which of the standard options do you recommend and why?Why: Guideline options include: Wedge or V excision with local flap reconstruction, or radiotherapy (external beam or brachytherapy) for commissure tumours or unfit patients.
Large, thick or node-positive disease
- For my situation (large, thick or node-positive disease), which of the standard options do you recommend and why?Why: Guideline options include: Resection with flap reconstruction, sentinel node biopsy or neck dissection, and postoperative radiotherapy; cisplatin for extranodal extension or positive margins.
- Am I a candidate for Cisplatin, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Unresectable or metastatic
- For my situation (unresectable or metastatic), which of the standard options do you recommend and why?Why: Guideline options include: Cemiplimab as for cutaneous squamous cell carcinoma, or pembrolizumab-based treatment as for head and neck squamous cell carcinoma.
- Am I a candidate for Cemiplimab, Pembrolizumab, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of KEYNOTE-048 apply to someone like me?Why: Trial populations differ from individual patients; ask how closely you match.
Prevention
- For my situation (prevention), which of the standard options do you recommend and why?Why: Guideline options include: Sun protection of the lips, smoking cessation, and treatment of actinic cheilitis.
Any stage
- Are there clinical trials I could join, for example of Cemiplimab?Why: Trials are how the next standard of care is set; asking early keeps options open.
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Why: Supportive care improves quality of life and helps patients complete treatment.
- I read that “Lip cancer in outdoor workers in sunny countries is under-recognised and under-protected”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
- I read that “Function and appearance after resection of more than half the lip”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
Newly diagnosed? Read the first 60 days with Lip cancer, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Direct links plus the targets, companies, and technologies of this cancer's products.
technologies
7targets
1drugs
3companies
2terms
1trials
1Latest papers
topQuery for this cancer: (TITLE:"Lip cancer" OR ABSTRACT:"Lip cancer" OR TITLE:"Lower lip squamous cell carcinoma" OR ABSTRACT:"Lower lip squamous cell carcinoma" OR TITLE:"Cancer of the lip vermilion" OR ABSTRACT:"Cancer of the lip vermilion") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Lip cancer, not a curated reading list.
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