Update: December 20one8
Any malignant tumor is dangerous because of its secrecy. how
usually from the beginning of growth to the time it is detected passes
significant amount of time. The tumor has time to spread
throughout the body and hit the lymph nodes. Unlike
most cancers, lip cancer is often diagnosed
in the initial stages. Due to this arrangement, it can
легко обнаружить и своевременно начать treatment.
It should be noted that in 98% of the tumor affects the lower lip.
The development of cancer on the upper lip is casuistry – in the world
registered only a few dozen cases. Considering this
moment, in most cases you can exclude the presence
oncological process, with the defeat of the upper lip.
What is lip cancer?
Despite the widespread use of the term “cancer”, its essence
not all patients understand. What is he like? Fine,
the whole organism consists of cells and connective tissue fibers.
A group of identical cells create tissue (muscle, epithelial,
glandular, etc.), which forms an organ (skin, kidney, liver and
The surface of the lip consists of several layers of the same
flat cells arranged in a specific sequence.
With the development of the cancer process, some of them change –
acquire a different form, change their metabolism and
resistance to various physical factors (heat, cold,
radiation). However, the most important change occurs in genetics
these cells – they begin to divide uncontrollably.
Lip cancer (squamous cancer) is a chronic disease, with
which changes the normal structure of cells and their
What is harmful to the body?
In cancer cells, the metabolism is altered, which is why
produce substances that poison people. Enough
multiplying, they can spread throughout the body, sifting
cancer cells in vital organs: heart, lungs, kidneys,
liver and others. Patients with fourth stage cancer often die.
not from the presence of excessively proliferating cells, but from failure
functions of the above bodies.
In addition, the malignant process affects the lymph nodes.
human and impaired immunity. Because of this, a cancer patient
lips are more susceptible to viral and bacterial
Causes of lip cancer
Why lip cancer appears is not clear to date. AT
in most cases, the occurrence of a tumor is often preceded by
any chronic inflammatory process. ATызвать его могут
- Chronic / regular lower lip infections
(bacterial or viral cheilitis);
- Permanent mechanical lip injury – the presence of abnormal
bite, sharp edge of a hard tooth, wrong
made dentures, etc .;
- Regular chemical / thermal damage to the skin of the lips –
It is not known whether lip cancer can arise from smoking,
drinking alcohol or hot food, but all these factors
can contribute to the development of the oncological process;
- Occupational hazards – regular skin contact with
various heavy metal compounds (bismuth, mercury, antimony and
etc.), arsenic, alkali / acid vapors;
- Specific climatic conditions – permanent
overheating / overcooling of the skin of the face, change of the mode of insolation
(tan with aggressive solar mode) cancer risk factors
Also, an important role belongs to the heredity of man. If
close relatives had any oncological process
(malignant and benign) or suspicion of them, it is
considered an important risk factor for cancer.
Precancerous lip disease
AT ходе многочисленных клинических исследований, доктора выяснили
– существуют болезни, которые всегда переходят в рак lips Their
called obligate (synonym – mandatory) precancerous conditions.
This process can be slowed down and even completely stopped, however
only if the patient has been prescribed adequate
treatment и принимает он его регулярно.
Also, there are diseases that with a high proportion
probabilities will lead to squamous lip cancer, without proper
therapy. Their называют факультативным (синоним – возможным)
There are only three diseases in this group. They
significantly different in appearance and treatment tactics, but
they have one thing in common – each sooner or later goes into the initial
стадию рака lips Brief description of obligate precancerous
The conditions and their characteristic symptoms are presented below:
|Disease name||ATнешние признаки болезни|
Continuing erosion on the surface of the lips, red or
Relapse occurs after one-3 months.
|Limited hyperkeratosis||With this pathology on the surface of the lips can be detected
small plot covered with a layer of horny scales. On their own
to separate them is usually quite difficult. Under the plot
keratinization is found bleeding epithelium. Scales can like
rise above the unchanged skin, so be immersed in
|Warty precancer||ATнешне выглядит, как узелок небольших размеров (3-9 мм). is he
located on the surface of the skin of the lips, has a red or
pale pink color and covered with small scales.
Each of these diseases is fairly easy to detect, thanks to
characteristic external signs. At the slightest suspicion of
obligate precancer lips, should immediately turn to
to the doctor.
This is a more numerous group, which is represented by the following
- Chronic cheilitis is an inflammation of the mucous membranes and skin of the lips, which
lasts longer than two months. Causes may be different: allergies,
bacterial or viral seeding, fungal infection and
- Radiation stomatitis is the most severe form of mucosal inflammation.
mouth (in particular – the alveolar process). Most often, arises
after radiotherapy or work with radioactive isotopes;
- Leukoplakia – keratinization of all oral mucous membranes, which
accompanied by inflammatory symptoms (pain when chewing,
redness of mucous membranes, edema, possible bleeding
- Papilloma is a benign tumor of the skin cells of the lips.
ATнешне выглядит, как образование округлой формы, несколько
protruding anteriorly. The color does not differ from those around
- Keratoacanthoma – another lip swelling, round or oval
forms with a slight depression / ulcer in the center. On their own
disappears within a few months (up to 6).
These diseases do not always lead to cancer of the lower lip, but their presence
– unfavorable prognostic sign. Timely therapy
helps to prevent the development of a malignant process that
cure is much more difficult than precancer.
Lip Cancer Symptoms
First signs of cancer
how правило, внешние изменения на губе проявляются несколько
later than signs of tumor intoxication. Sick can
complain of constant weakness that persists for
all days. There is a decrease in appetite and a slight loss in
body weight (within 2-3 kg). The patient is often worried about the headache.
pain and a slight fever for quite a long time (until
These signs of lip cancer may be the only manifestations.
diseases. how правило, внешние признаки опухоли начинают появляться
a few weeks or even months after development
how выглядит рак губы?
AT области нижней губы формируется small участок, покрытый
grayish crust. how правило, он несколько возвышается над
surrounding skin. In the initial stages of the disease, it is painless
when probing and much denser than unchanged tissue
If you remove the crust, then under it you can find red bumps
various size, firmly adhered to the underlying skin.
Lip cancer progression
If, when detecting the first signs of cancer, the lip is not started.
treatment – опухоль продолжит развиваться. is heа значительно увеличится
in size, take the form of a large node and will hit the surrounding
tissue. The patient will have new symptoms, such as:
- Pain in the lower lip – can be different
intensity, from slight discomfort to unbearable pain
irritations. how правило, усиливается при пальпации;
- Itchy skin of the lips;
- Difficulty in eating – due to pain
the patient spares his lower lip.
In some patients, some of the tumor tissue may
self nekrotizirovatsya (dead). how будет выглядеть
lip cancer in this case? is he примет форму язвы. AT центре будет
be determined by a groove with jagged edges, painless at
probing Along the edges appear a significant hardening of the skin,
which may extend to the chin or cheeks.
With a long process, the cancer of the lip begins to affect
surrounding lymph nodes (mental, occipital, cervical and
etc.) and spread metastases – parts of tumor cells. Getting into
to different organs, they continue to multiply, which leads to
disruption of vital functions.
Stage Lip Cancer
AT диагнозе пациента обязательно указывают стадию рака губы,
for example, stage III squamous cell carcinoma of the lower lip
(T2NoneM0). What do these letters mean?
TNM, numbers attached to them and stage? ATсе обозначения, указанные
the diagnosis is necessary for one purpose – to determine
the prevalence of cancer in the body.
The TNM classification is an abbreviation of the three words characterizing
- Tumor size (Tumor) – can take values from the onest to
fourth Если раку присваивается значение Tone-T3,
это значит, что поражены только ткани lips Tfour это, как
usually inoperable tumors that have germinated into the surrounding
organs (jaw, tongue, throat, etc.);
- Damage to lymph nodes (Nodus)
- N0 — отсутствие повреждений лимфатических
- None — небольшое увеличение одного близлежащего
lymph nodes (up to 3 cm);
- N2 — если в одном лимфоузле отмечается big hearth
cancer growth (node more than 6 cm) or in several nodes
small foci (up to 6 cm);
- N3 – несколько лимфатических узлов значительно
enlarged (more than 6 cm).
- N0 — отсутствие повреждений лимфатических
- The presence of metastases (Metastasis) – the absence of metastases
обозначается М0. Availability – M
Given these three points, the cancer stage is being set:
|Any value||Any value||one|
Why do you need to know the stage of lip cancer? It will depend on it
tactics of doctors, the choice of treatment and prognosis for the patient. TO
this issue should be approached very carefully and used
all necessary diagnostic methods to determine
the prevalence of the tumor.
Lip cancer diagnosis
Detect a tumor on the lower lip can be with the naked eye,
however, in order for the diagnosis to become reliable, it must be confirmed.
laboratory research methods. Examine the spread
tumors, the presence of metastases and lesions of the lymph nodes by using
To date, this method is the “gold standard”
in the diagnosis of any cancer. Its principle is simple – you need to take
sample cells from a suspicious area, stain and see them
under the microscope. If they are different from normal or observed
their excessive division, this is a reliable confirmation of cancer
There are several methods for collecting cells: scraping, puncture (puncture and
aspiration), thin section with scalpel or conchotome, etc.
The preferred method is determined individually.
Cancer cells secrete special chemicals that
can be detected in the patient’s blood. This method is used.
much less frequently than cytology, since it is expensive and not
достаточно точный (вероятность ошибки — one5-2four%). how правило,
biomarkers are examined if it is impossible to see
cells under the microscope or the doctor has doubts
correctness of the diagnosis.
P53 and KI-67 markers are specific for lip cancer.
The most affordable method that allows you to evaluate
the presence / absence of germination of cancer in the bone. Tочность его
значительно ниже, чем на TOT, однако благодаря низкой цене он
widespread. With Tfour на прицельном
image you can see the center of blackout, irregular shape. how
as a rule, it fanlikely diverges in different directions – this
characteristic sign of cancer growth.
These research methods allow you to accurately assess the spread
cancer in the specified area. Via МРT оценивают поражение мягких
тканей (языка, глотки, лимфатических узлов и etc.). On computer
tomogram better identifies changes in the bones.
Modern way of assessing tumor growth. Via
A special device that emits waves of a certain frequency,
изучаются подозрительные tissue. The method is absolutely safe
human exposure does not occur. По точности он соотносим с МРT
или TOT. The disadvantage is the low prevalence in the Russian Federation.
На чем основывается treatment рака губы? Tumor cells less
resistant to various external factors, such as cold, radiation,
UV light, etc. ATсе они разрушают измененные ткани,
leaving the healthy almost intact.
The method of treatment is chosen depending on the stage of distribution.
lower lip cancer in the body. Local methods recommended
- if it is limited to the lower lip and the underlying tissues;
- not eliminated in the lymph nodes;
- no metastases in other organs.
In other words, they are used for tumors.
Tone-fourN0M0. AT остальных случаях, при
lymph nodes or metastasis are used
Methods of local treatment
This new technology can significantly improve the forecast.
patient after treatment and reduce the risk of recurrence
diseases. The principle of the method is as follows: first lip cancer and the area around
processed by cold, after which the affected tissues are excised
scalpel or coagulated (argon-plasma, electric or
another modification of the scalpel). Cold kills cancer cells and
creates a boundary shaft that allows the surgeon to hold
operation with high accuracy.
TOомбинация хирургического удаления рака губы и облучения
affected area is widespread in Russia. After
excision of the tumor there is a possibility that part of the pathological
cells persist. To permanently destroy these remnants,
retaining healthy tissue, use targeted radioactive
The most modern method that has proven its high
efficiency and safety. It requires three
- Photosensitizer – a drug that increases sensitivity
cancer cells to ultraviolet;
- Ultraviolet light source;
- Access of oxygen to the affected area.
The patient is given a special photosensitizer drug, after
which is directed to the cancer of the lips with ultraviolet light. With
photodynamic therapy virtually no adverse reactions,
and there is a small number of relapses. TO сожалению, в
Russia, this method is very limited, due to the high
If the tumor has already spread throughout the body, act
only for cancer of the lower lip is practically ineffective. Is not
will stop the progression of cancer, but in some cases, it may
improve the condition of the patient. With наличии метастазов в органы и
lymph nodes, chemotherapy is the preferred treatment.
AT настоящее время, существует большое количество препаратов,
oppressing cancer growth and destroying altered cells. ATыбрать
optimal combination of drugs and make an adequate prescription
can only oncologist.
With своевременно начатом лечении ранних стадий рака губы (вплоть
before the third) the prognosis is favorable. The use of modern
methods allowed to ensure a 5-year survival rate
90% of patients. Рецидивы опухолей возникает в 30-3four% случаев.
Если рак губы обнаруживается на four-й стадии, вылечить болезнь
often impossible. Tак как устранить все очаги опухолевого
growth (metastases, lymph nodes, head tissue) is extremely
heavy. Remission can be achieved in 20-30% of patients. AT остальных
cases, palliative treatments are used to facilitate
Frequently asked questions from patients
ATопрос: how будет проявляться наличие метастазов?
It depends on the affected organ. If metastases are detected
in the lungs, it may cause shortness of breath, dry cough, pain in
rib cage. Damage to the kidneys can be a violation of their
functions (delayed breakdown products in the blood, frequent
urination), pain in the lumbar region. Heart metastases
may provoke the development of chest pains, edema in the area
legs, shortness of breath.
ATопрос: After облучения рака нижней губы появилась
strong sensitivity to touch to the lip and periodic
the pains. Why these symptoms?
Most likely, these are post-radiation reactions. Due to exposure
radioactive radiation could damage the nerve endings and
the above symptoms occur.
ATопрос: Что делать, если treatment рака губы
неэффективно (four-я стадия рака с метастазами)?
AT этом случае, необходимо адекватно обезболить пациента и
provide high-quality care: feeding (possibly through a probe),
bed and bed linen change, minimal physical
activity. The first-line analgesic drug is usually
выбирают Tрамадол. With его неэффективности доктор назначает
ATопрос: howими способами можно восстановить
AT настоящее время, существуют методики кожной пластики, которые
allow you to close the defect after surgery. Withменяют их, в основном,
only specialized plastic clinics.
ATопрос: ATозможно ли применение физиотерапии для
cure lower lip cancer?
TOатегорически запрещено. Any physiotherapy stimulates growth.
раковых сосудов, что приведет к прогрессированию diseases.