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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.
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 ("Date Last Modified") 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 PDQ Adult Treatment Editorial Board.
CONTENTS
- General Information About Lip and Oral Cavity Cancer
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Lip and oral cavity cancer is a disease in which malignant (cancer) cells form in the lips or mouth.
The oral cavity includes the following:
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. These 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.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for lip and oral cavity cancer include the following:
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.
The following tests and procedures may be used:
Certain factors affect prognosis (chance of recovery) and treatment options.
Prognosis depends on the following:
For patients who smoke, the chance of recovery is better if they stop smoking before beginning radiation therapy.
Treatment options depend on the following:
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 NCI website.
- Stages of Lip and Oral Cavity Cancer
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After lip and oral cavity cancer has been diagnosed, tests are done to find out if cancer cells have spread within the lip and oral cavity or to other parts of the body.
The process used to find out if cancer has spread within the lip and oral cavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose lip and oral cavity cancer are also used to stage the disease. (See the General Information section.)
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if lip cancer spreads to the lung, the cancer cells in the lung are actually lip cancer cells. The disease is metastatic lip cancer, not lung cancer.
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
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 IV
Stage IV is divided into stages IVA, IVB, and IVC.
Lip and oral cavity cancer can recur (come back) after it has been treated.
The cancer may come back in the lip or mouth or in other parts of the body.
- Treatment Option Overview
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There are different types of treatment for patients with lip and oral cavity cancer.
Different types of treatment are available for patients with lip and oral cavity cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. 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.
Patients 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.
Treatment will be overseen by a medical oncologist, a doctor who specializes in treating people with cancer. Because the lips and oral cavity are important for breathing, eating, and talking, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer the patient to other health professionals with special training in the treatment of patients with head and neck cancer. These include the following:
Two types of standard 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 the following:
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.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
The way the radiation therapy is given depends on the type and stage of the cancer being treated. 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.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Hyperfractionated radiation therapy
Hyperfractionated radiation therapy is radiation treatment in which the total dose of radiation is divided into small doses and the treatments are given more than once a day.
Hyperthermia therapy
Hyperthermia therapy is a treatment in which body tissue is heated above normal temperature to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.
Treatment for lip and oral cavity cancer may cause side effects.
For information about side effects caused by treatment for cancer, see our Side Effects page.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order 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). These tests are sometimes called follow-up tests or check-ups.
- Treatment of Stage I Lip and Oral Cavity Cancer
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For information about the treatments listed below, see the Treatment Option Overview section.
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 the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
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 clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
- Treatment of Stage II Lip and Oral Cavity Cancer
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For information about the treatments listed below, see the Treatment Option Overview section.
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 the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
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 the following:
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
- Treatment of Stage III Lip and Oral Cavity Cancer
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For information about the treatments listed below, see the Treatment Option Overview section.
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 the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
Upper gingiva
If cancer is in the upper gingiva (gums), treatment may include the following:
Hard palate
If cancer is in the hard palate (the roof of the mouth), treatment may include the following:
Lymph nodes
For cancer that may have spread to lymph nodes, treatment may include the following:
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
- Treatment of Stage IV Lip and Oral Cavity Cancer
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For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stages IVA, IVB, and IVC 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 the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
Upper gingiva or hard palate
If cancer is in the upper gingiva (gums) or hard palate (the roof of the mouth), treatment may include the following:
Lymph nodes
For cancer that may have spread to lymph nodes, treatment may include the following:
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
- Treatment of Recurrent Lip and Oral Cavity Cancer
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For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of recurrent lip and oral cavity cancer may include the following:
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
- To Learn More About Lip and Oral Cavity Cancer
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For more information from the National Cancer Institute about lip and oral cavity cancer, see the following:
For general cancer information and other resources from the National Cancer Institute, see the following:
- About This PDQ Summary
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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 Spanish.
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 PDQ Adult Treatment Editorial Board.
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 NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
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The best way to cite this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Lip and Oral Cavity Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/head-and-neck/patient/adult/lip-mouth-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389326]
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