Lip cancer accounts for 15% of all malignant diseases of face and head. Lower lip is affected in more than upper lip and cancer at one of the angles of the mouth. Males are affected more.

Incidence increases with advancing age with highest incidence in the sixth decade. There is correlation between lip cancer and exposure to sunlight. Persons with light colored skin, when exposed to sunlight appear to be highly susceptible.

Persons, who work in outdoors or at the higher elevations where the effects of actinic irradiation are stronger, are more susceptible to the development of this cancer. Other predisposing factors are syphilis, excessive use of tobacco, heavy alcohol consumption and previous gamma irradiation.

Patient may give previous history of blistering due to actinic cheilitis, thickening due to solar keratosis or white patches due to leukoplakia. Chain pipe smokers are affected more.

There is a nodule or an ulcer which fails to heal. Lesion may bleed or there may be offensive discharge. Lesion is painless. There is swelling under the chin. The edge of the ulcer is proliferated and everted. This is red and bleeds easily. Discharge is thin, watery and slightly blood stained. It is often infected though rarely purulent.

The lump is invariably fixed to the subcutaneous structures of the lip, but can be moved with the lip. It is usually separated from the jaw and is freely mobile over the jaw. Only in late cases it may be fixed to the gum and jaw.

Lymph node involvement may be noted within three months of the disease but frequently it is delayed for nine months to twelve months.

Treatment-

1.   Small primary lip cancers of the well differentiated type are adequately treated by local resection.

2.   For larger lesions excision of more than half of the lip may be required.

3.   Radiotherapy.