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Lip and oral cavity cancer is a disease that starts in lips or mouth.
The oral cavity refers to the mouth. It includes:
Anatomy of the oral cavity. The oral cavity includes the lips, hard palate (the bony front portion of the roof of the mouth), soft palate (the muscular back portion of the roof of the mouth), retromolar trigone (the area behind the wisdom teeth), front two-thirds of the tongue, gingiva (gums), buccal mucosa (the inner lining of the lips and cheeks), and floor of the mouth under the tongue.
Most lip and oral cavity cancers start in squamous cells, the thin, flat cells lining the inside of the lips and oral cavity. Cancers that start in squamous cells are called squamous cell carcinomas. Cancer cells may spread into deeper tissue as the cancer grows. Squamous cell carcinoma usually develops in areas of leukoplakia (white patches of cells that do not rub off).
Lip and oral cavity cancer is a type of head and neck cancer.
Tobacco and alcohol use can affect the risk of lip and oral cavity cancer.
Lip and oral cavity cancer is caused by certain changes to the way lip and oral cavity cells function, especially how they grow and divide into new cells. There are many risk factors for lip and oral cavity cancer, but many do not directly cause cancer. Instead, they increase the chance of DNA damage in cells that may lead to lip and oral cavity cancer. Learn more about how cancer develops at
A risk factor is anything that increases the chance of getting a disease. Some risk factors for lip and oral cavity cancer, such as tobacco and alcohol use, can be changed. However, risk factors also include things people cannot change, like their genetics. Learning about risk factors for lip and oral cavity cancer can help you make changes that might lower your risk of getting it.
Risk factors for lip and oral cavity cancer include:
Learn more about
Having one or more of these risk factors does not mean that you will get lip and oral cavity cancer. Many people with risk factors never develop lip and oral cavity cancer, while others with no known risk factors do. Talk with your doctor if you think you may be at risk.
Signs of lip and oral cavity cancer include a sore or lump on the lips or in the mouth.
These and other signs and symptoms may be caused by lip and oral cavity cancer or by other conditions. Check with your doctor if you have any of the following:
Lip and oral cavity cancer may not have any symptoms and is sometimes found during a regular dental exam.
Tests that examine the mouth and throat are used to diagnose and stage lip and oral cavity cancer.
If you have symptoms that suggest lip and oral cavity cancer, your doctor will need to find out if these are due to cancer or another problem. They will ask when the symptoms started and how often you have been having them. They will also ask about your personal and family health history and do a physical exam. Based on these results, the doctor may recommend other tests. If you are diagnosed with lip and oral cavity cancer, the results of these tests will help you and your doctor plan treatment.
The following tests and procedures are used to diagnose and stage lip and oral cavity cancer:
Some people decide to get a second opinion.
You may want to get a second opinion to confirm your cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. They may agree with the first doctor, suggest changes or another treatment approach, or provide more information about your cancer.
To learn more about choosing a doctor and getting a second opinion, see
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis depends on:
For patients who smoke, the chance of recovery is better if they stop smoking before beginning radiation therapy.
Treatment options depend on:
Patients who have had lip and oral cavity cancer have an increased risk of developing a second cancer in the head or neck. Frequent and careful follow-up is important. Clinical trials are studying the use of retinoid drugs to reduce the risk of a second head and neck cancer. Information about ongoing clinical trials is available from the
Cancer stage describes the extent of cancer in the body.
Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. Knowing the cancer stage helps plan treatment.
There are several staging systems for cancer that describe the extent of the cancer. Lip and oral cavity cancer staging usually uses the TNM staging system. The cancer may be described by this staging system in your pathology report. Based on the TNM results, a stage (I, II, III, or IV, also written as 1, 2, 3, or 4) is assigned to the cancer. When talking to you about your diagnosis, your doctor may describe the cancer as one of these stages.
Learn more about
The following stages are used for lip and oral cavity cancer:
Stage 0 (carcinoma in situ)
In stage 0, abnormal cells are found in the lining of the lips and oral cavity. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).
Stage I (also called stage 1) lip and oral cavity cancer
In stage I, cancer has formed. The tumor is 2 centimeters or smaller and the deepest point of tumor invasion is 5 millimeters or less.
Tumor sizes are often measured in millimeters (mm) or centimeters. Common items that can be used to show tumor size in mm include: a sharp pencil point (1 mm), a new crayon point (2 mm), a pencil-top eraser (5 mm), a pea (10 mm), a peanut (20 mm), and a lime (50 mm).
Stage II (also called stage 2) lip and oral cavity cancer
In stage II, the tumor:
Stage III (also called stage 3) lip and oral cavity cancer
In stage III, the tumor:
Stage IV (also called stage 4) lip and oral cavity cancer
Stage IV is divided into stages IVA, IVB, and IVC.
Stage IVC lip and oral cavity cancer is also called metastatic lip and oral cavity cancer. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if lip and oral cavity cancer spreads to the lung, the cancer cells in the lung are actually lip and oral cavity cancer cells. The disease is called metastatic lip and oral cavity cancer, not lung cancer. Learn more in
Lip and oral cavity cancer can recur (come back) after it has been treated.
Recurrent lip and oral cavity cancer is cancer that has come back after it has been treated. If lip and oral cavity cancer comes back, it may come back in the lip, mouth, or other parts of the body. Tests will help determine where in the body the cancer has returned. The type of treatment that you have for recurrent lip and oral cavity cancer will depend on where it has come back.
Learn more in
There are different types of treatment for people with lip and oral cavity cancer.
Different types of treatments are available for lip and oral cavity cancer. You and your cancer care team will work together to decide your treatment plan, which may include more than one type of treatment. Many factors will be considered, such as the stage of the cancer, your overall health, and your preferences. Your plan will include information about your cancer, the goals of treatment, your treatment options and the possible side effects, and the expected length of treatment.
Talking with your cancer care team before treatment begins about what to expect will be helpful. You'll want to learn what you need to do before treatment begins, how you'll feel while going through it, and what kind of help you will need. Learn more at
People with lip and oral cavity cancer should have their treatment planned by a team of doctors who are expert in treating head and neck cancer.
An oncologist, a doctor who specializes in treating people with cancer, oversees treatment for lip and oral cavity cancer. Because the lips and oral cavity are important for breathing, eating, and talking, you may need special help adjusting to the side effects of the cancer and its treatment. The oncologist may refer you to other health care providers who are experts in treating head and neck cancer and also specialize in other areas of medicine. Other specialists may include:
The following types of treatment are used:
Surgery
Surgery (removing the cancer in an operation) is a common treatment for all stages of lip and oral cavity cancer. Surgery may include:
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Learn more about
Radiation therapy
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing by damaging their DNA. External and internal radiation therapy are used to treat lip and oral cavity cancer:
Radiation therapy may work better in patients who have stopped smoking before beginning treatment. It is also important for patients to have a dental exam before radiation therapy begins so that existing problems can be treated.
Learn more about
Immunotherapy
Immunotherapy helps a person's immune system fight cancer. Your doctor may suggest biomarker tests to help predict your response to certain immunotherapy drugs. Learn more about
Immunotherapy drugs used to treat squamous cell carcinoma of the lip and oral cavity cancer that has come back or spread to other parts of the body include:
Learn more about
New types of treatment are being tested in clinical trials.
For some people, joining a clinical trial may be an option. There are different types of clinical trials for people with cancer. For example, a treatment trial tests new treatments or new ways of using existing treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
You can use the
Learn the basics about clinical trials at
Follow-up care may be needed.
As you go through treatment, you will have follow-up tests or check-ups. Some tests that were done to diagnose or stage the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back).
Learn about the treatments listed below in the Treatment Option Overview.
Treatment of stage I lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include:
Front of the tongue
If cancer is in the front of the tongue, treatment may include:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include:
Upper gingiva or hard palate
If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment is usually surgery (wide local excision) with or without radiation therapy.
Use our
Learn about the treatments listed below in the Treatment Option Overview.
Treatment of stage II lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include:
Front of the tongue
If cancer is in the front of the tongue, treatment may include:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include:
Upper gingiva or hard palate
If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment may include:
Use our
Learn about the treatments listed below in the Treatment Option Overview.
Treatment of stage III lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include surgery and external radiation therapy with or without internal radiation therapy.
Front of the tongue
If cancer is in the front of the tongue, treatment may include:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include surgery (wide local excision) with or without radiation therapy. Radiation may be given before or after surgery.
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include surgery to remove the tumor, lymph nodes, and part of the jawbone, with or without radiation therapy.
Upper gingiva
If cancer is in the upper gingiva (gums), treatment may include:
Hard palate
If cancer is in the hard palate (the roof of the mouth), treatment may include:
Lymph nodes
For cancer that may have spread to lymph nodes, treatment may include radiation therapy and/or surgery (neck dissection).
Use our
Learn about the treatments listed below in the Treatment Option Overview.
Treatment of stages IVA and IVB lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include surgery and external radiation therapy with or without internal radiation therapy.
Front of the tongue
If cancer is in the front of the tongue, treatment may include:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include surgery (wide local excision) and/or radiation therapy.
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include surgery before or after radiation therapy.
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include surgery and/or radiation therapy.
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include surgery to remove the tumor, lymph nodes, and part of the jawbone, followed by radiation therapy.
Upper gingiva or hard palate
If cancer is in the upper gingiva (gums) or hard palate (the roof of the mouth), treatment may include surgery with radiation therapy.
Lymph nodes
For cancer that may have spread to lymph nodes, treatment may include radiation therapy and/or surgery (neck dissection).
Use our
Learn about the treatments listed below in the Treatment Option Overview.
Treatment of metastatic (IVC) and recurrent lip and oral cavity cancer may include:
Use our
For more information from the National Cancer Institute about lip and oral cavity cancer, visit:
For general cancer information and other resources from the National Cancer Institute, visit:
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the treatment of adult lip and oral cavity cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials can be found online at
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Lip and Oral Cavity Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at:
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in
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Last Revised: 2024-09-10
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