Diagnosing Lip Cancer
Lip cancer is the most common cancer of the mouth. It begins in the tissue lining the mouth, specifically the lips.
To diagnose lip cancer, several examinations, screening tests, and procedures are typically done. These help confirm a diagnosis and determine the type, severity, or stage of the cancer.
Examinations, screening tests, and procedures used to diagnose lip cancer include:
- Physical examination: A doctor will review a person's symptoms, medical history, and risk factors. They will closely inspect the lips and the inside of the mouth for lumps and abnormalities. The doctor may also check the lymph nodes in the neck for swelling.
- Biopsy: If lip cancer is suspected, a biopsy is typically performed to confirm the diagnosis. During a biopsy, a small sample of skin from the affected area is taken and examined under a microscope for signs of cancer.
Additional tests: Once lip cancer is confirmed, additional tests are ordered to determine the type, severity, or stage of the cancer. These tests may include:
- Imaging tests: Imaging tests such as CT (computed tomography) scans, MRI (magnetic resonance imaging) scans, PET (positron emission tomography) scans, or chest X-rays may be done to look for any spread of the cancer to other parts of the body.
- Endoscopy: An endoscopy involves using a thin tube with a camera to examine the inside of the mouth and throat for any signs of cancer that may have spread from the lips.
- Blood tests: A complete blood count (CBC) may be done to evaluate overall health and check for any abnormalities.
These examinations, tests, and procedures help identify factors or indicators of the type, severity, or stage of lip cancer:
- Tumor size and extent (T): Doctors check the size of the tumor and determine which tissues on the lips or inside the mouth it affects.
- Lymph node involvement (N): Doctors check whether the cancer has spread to nearby lymph nodes. They also assess how many nodes have cancer cells and their size.
- Metastasis (M): Metastasis refers to when cancer spreads to another part of the body. Doctors evaluate whether there is any spread beyond the lips or mouth.
By assessing these factors through examinations and tests, doctors assign a stage to lip cancer using a system known as TMN staging:
- Stage 0: The cancer is in the upper layer of tissue and has not spread elsewhere.
- Stage 1: The cancer is smaller than 2 centimeters (cm) and has not spread elsewhere.
- Stage 2: The cancer is between 2 and 4 cm and has not spread elsewhere.
- Stage 3: The cancer is larger than 4 cm but has not spread elsewhere or has spread to one lymph node on the same side as the tumor.
In summary, diagnosing lip cancer involves physical examinations, biopsies, imaging tests like CT scans or MRI scans, endoscopy procedures, and blood tests. Specialists such as doctors, nurses, physician's assistants, and lab technicians may be involved in this process. Additional examinations and tests are done to determine factors such as tumor size, lymph node involvement, metastasis status, and overall stage of lip cancer.