While the danger of excessive sun exposure causing skin cancer is well known, lip cancer, which often appears to be a cold sore, often goes undiagnosed, according to the Massachusetts Dental Society.

Oral cavity cancers are generally caused by tobacco use. But sun is the major cause of lip cancer, said David Emanuel, a dentist and oral surgeon.

Emanuel, who practices with MetroWest Oral Surgical Associates in Framingham, Northborough and Milford, has treated a half-dozen cases of lip cancer in the past five years, he said.

Surgery to excise the cancer, followed by reconstruction of the lip, and radiation are the primary treatment methods, he said.

"As with any cancer, if it's allowed to go ahead and spread, it can certainly be devastating to one's health," Emanuel said. "Fortunately, if you were to pick a type of cancer to have in the head or neck area, your conventional lip cancers are very treatable in the early stages. And they are treatable without much morbidity."

Lip cancer, often discovered by dentists, appears most often on the lower lip and most commonly affects people over 45, according to the Massachusetts Dental Society. But fair-skinned people and anyone exposed to sunlight for long periods of time are at risk, the group warns. The cancer is most prevalent in men.

Lip cancer often looks like a crusting or sore on the lip that does not go away, Emanuel said. If left untreated, the cancer can spread to lymph nodes and lungs, he said.

Emanuel recommended not smoking and protecting oneself from the sun by wearing hats that provide cover for one's face, using sunscreen of SPF 30 or higher and lip balms with an SPF. Limiting sun exposure is important not only in the summer, but also in the winter when people are likely to be exposed to the sun while skiing or snowboarding, he said.

"The higher you go with the SPF, the better," Emanuel said.

It's unclear how many cases of lip cancer there are in the United States. The American Cancer Society expects 28,260 Americans to be diagnosed with all types of oral cavity cancers this year, but does not track how many of those cancers affect the lip, said Dr. Lisa McCoy, director of cancer detection for the society's New England division.

More than 1 million cases of skin cancer are expected to be diagnosed annually nationwide, according to the federal Centers for Disease Control and Prevention.

Health officials have observed a steady increase in skin cancer cases over the past two decades. The World Health Organization and United Nations Environmental Program last year warned that depletion of the Earth's protective ozone layer increases the risk of skin cancer.

Emanuel blamed skin cancer's prevalence on increased outdoor activity, as well as increased longevity.

McCoy said increased outdoor activity may well play a role in a rise in skin cancer.

"I'm just hoping our increased efforts on skin cancer awareness are keeping up with increased physical activity," she said.

Lip cancer facts:

Lip cancer is most commonly a squamous cell carcinoma, affecting areas of the body that have been exposed to the sun for prolonged periods. Warning signs of squamous cell cancer include:

A wart-like growth that crusts and occasionally bleeds.

A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds.

An open sore that bleeds and crusts and persists for weeks.

An elevated growth with a central depression that occasionally bleeds. A growth of this type may rapidly increase in size.

Regardless of appearance, any change in a preexisting skin growth, the development of a new growth or an open sore that fails to heal, should prompt an immediate visit to a physician. If it is a precursor condition, early treatment will prevent it from developing into a squamous cell carcinoma. Often, all that is needed is a simple surgical procedure or application of a topical chemotherapeutic agent.

Herald Interactive Tools
By Jon Brodkin / News Staff Writer
Tuesday, July 13, 2004