Saturday, January 14, 2006

cancer, lip

Lip cancer is the most common cancer of the head and neck, accounting for approximately 30 percent of these cancers. Lip cancer is predominately seen in cigarette smokers in the sixth or seventh decades, and in blond, light-complexioned males who have occupations with sun exposure. Women are at less risk and it is thought that lipstick affords some protection. Since melanin blocks ultraviolet absorption, the incidence is lower in dark-skinned people. About 95 percent of lip cancers are squamous cell carcinomas involving the lower lip. The early lesion may be a persistent "cold sore" with crusting, peeling, or mild ulceration that is painless. The lesions are usually present six to 24 months before treatment is initiated. These lesions grow slowly and rarely metastasize. The tendency is to spread laterally rather than deeply. Prognosis is excellent regardless of treatment. Both surgical procedures and radiation therapy are usually successful.
However, with cancer of the upper lip, the prognosis is poor. It arises spontaneously, metastasizes early and spreads more quickly. Recurrence rates are also higher. Following treatment, patients will frequently need rehabilitative training, including speech therapy. They also need to be counseled on proper oral habits, nutrition, and the need for elimination or reduction of tobacco and alcohol products. Postoperative management is necessary to closely watch for any recurrence.
Ballenger. J. J. Diseases of the Nose, Throat. Ear, Head and Neck, 13th ed. Philadelphia: Lea & Febiger, 1985.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.

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