Cancer of the lip: A consideration of its prophylaxis, diagnosis, and treatment

Abstract

1. 1. Any “crack,” “fever blister,” or unexplained “sore,” especially if on the lower lip of a man, which does not heal within four weeks, must be considered cancer until proved otherwise by biopsy or dark-field examination. Cancer and syphilis can coexist. 2. 2. The incidence of cancer of the lip can be reduced by (a) protection against sunburn, (b) avoidance of burns by short cigarettes, hot pipes, etc., (c) relief from irritation by sharp, jagged or overhanging teeth, and (d) eradication of leucoplakia and papillomas. 3. 3. The primary lesion of cancer on the lip can be controlled by radiotherapy or surgery. Radiotherapy is generally preferred by us due to its simplicity, a better cosmetic result, and less interference with function. Resection and plastic repair are advised for the ulcerating, destructive cancer and the rare radioresistant lesion. Systematic follow-up is an essential part of proper care. 4. 4. Metastasis occurs first to the submaxillary and submental lymph nodes and submaxillary salivary glands, with later extension to the cervical nodes, mandible, and adjacent structures. 5. 5. The treatment of metastases is an individual problem. The indicated management depends primarily on the stage and secondarily on the grade of the cancer as detailed in the paper. 6. 6. The prospects of a “five-year cure” are 90 to 95 per cent without apparent metastases, 33 1 3 per cent with an early single focus of metastasis in the suprahyoid structures and only 1 per cent after metastases are present in the cervical lymph nodes. The importance of early correct diagnosis and adequate treatment is obvious.