What warts can lead to cancer? Let's discuss it with a dermatologist

Lip cancer is a malignant neoplasm that consists of elements of the integumentary epithelium of the red border of the lips. A tumor on the upper lip appears rarely. Over time, lip cancer spreads to the bones of the lower jaw. Atypical cells are transported with lymph to the lymph nodes, resulting in the appearance of new malignant foci.

Doctors at the Yusupov Hospital carry out early diagnosis of lip cancer using modern research methods. Oncologists provide radiation therapy and perform gentle surgical interventions. In the later stages of lip cancer, complex therapy is used. Early diagnosis of a malignant lip tumor and adequate therapy can not only save the patient’s life, but also avoid cosmetic defects after surgery.

Lip cancer - what is it?

Depending on the type of tumor growth, the following forms of lip cancer are distinguished:

• Papillary;
• warty;
• Ulcerative;
• Ulcerative-infiltrative.

A malignant tumor of the lip in 95% of cases is represented by keratinizing squamous cell carcinoma. In 5% of cases, histologists have squamous cell non-keratinizing cancer of the lip mucosa. A tumor of the lip, which from the inside, on the mucous membrane, is characterized by a malignant course (infiltrative growth and early metastasis to regional lymph nodes).

A tumor of the lower lip most often affects the border of the lower lip. A crack, ulcer or swelling forms on it, which looks like a wart. The disease is predominantly diagnosed in people over 60 years of age.

Cancer of the upper lip occurs less frequently than the lower lip, but the tumor is more aggressive. Upper lip cancer has a high risk of metastasis and spreads quickly. This is explained by the fact that the malignant tumor is located close to the nasal cavity, where the blood supply system is developed. A tumor on the inside of the lip is dangerous because it quickly grows into the soft tissue.

Melanoma on the lip is 10 times less common than squamous cell carcinoma of the lip, but is characterized by a high degree of malignancy. Basically, the tumor is located on the red border of the lower lip. It penetrates deeply into tissues, quickly transfers to nearby tissues and gives metastases.

At the Yusupov Hospital, oncologists make a diagnosis of lip cancer using the following methods:

• Examination with the naked eye and using stomatoscopy;
• Cytological examination of impression smears from a tumor ulcer;
• Histological examination of lymph node punctate.

After establishing the primary diagnosis, a comprehensive examination of the patient is carried out.

Causes of lip cancer

Lip cancer develops for many reasons:

• From smoking;
• After a long stay in the sun;
• As a result of inflammatory processes of an infectious and non-infectious nature;
• Under the influence of high temperatures;
• In the presence of microtraumas;
• Due to prolonged exposure to chemicals.

Lip cancer often develops from smoking. Men get lip cancer much more often than women. Currently, the trend is changing, because many women suffer from tobacco addiction. Doctors believe that lip cancer develops due to smoking strong cigarettes for a long time.

The average smoker smokes at least ten cigarettes a day. In this case, the paper surface is constantly in contact with the lips. The skin here is especially delicate and sensitive. Microcracks appear on its surface. They are invisible to others and do not cause problems for the smoker. Damaged areas of the epithelium are affected by tobacco smoke. It contains a lot of harmful substances. Skin cells begin to degenerate.

The cause of mechanical trauma that causes lip cancer can be improperly made dentures, the habit of holding various objects with the lips (nails, the mouthpiece of a smoking pipe), or biting the lower lip. The mechanism of development of lip cancer is as follows: a long-term non-healing crack, wound, inflammation on the lip, papilloma develops into leukoplakia, Manganotti cheilitis, keratoacanthoma, warty form of dyskeratosis or other precancerous diseases. Against this background, lip cancer occurs.

When should a malignant process be suspected?

A long-term pathological process on the skin of the lip without a tendency to cure with active therapeutic measures should always raise suspicion that it is of poor quality. If the “spot” does not respond to local treatment and increases in size, you should immediately consult an oncologist.

The appearance of ulcerations and bleeding, or any thickening where there used to be soft skin, should be alarming. These symptoms can be either single or in combination, but even with a single symptom, the lack of treatment result within 3 weeks can be regarded as a bad sign, which can only be “clarified” by a biopsy of the skin defect. And the sooner it is done, the better.

Precancerous diseases of the lips

Lip cancer does not occur on healthy mucous membranes. Malignant neoplasms develop against the background of obligate or facultative precancerous diseases. Obligate precancerous diseases include:

• Abrasive precancerous cheilitis Manganotti;
• Warty precancer of the red border;
• Limited precancerous hyperkeratosis of the red border.

Facultative precancerous diseases with greater potential for malignancy are:

• Erosive and verrucous leukoplakia of the lip;
• Papilloma;
• Keratoacanthoma;
• Cutaneous horn.

Malignant neoplasms of the lip can develop against the background of optional precancerous diseases with less potential malignancy:

• Flat leukoplakia of the lip;
• Chronic ulcers;
• Ulcerative and hyperkeratotic forms of lupus erythematosus and lichen planus;
• Chronic cracked lips;
• Post-X-ray cheilitis;
• Meteorological and actinic cheilitis.

Background conditions that are precursors to lip cancer include scars after burns, trauma, surgery, and benign neoplasms.

Heilith Manganotti

Abrasive precancerous Manganotti cheilitis occurs in older people. Small, round erosions appear on the lips, which do not heal for a long time. They have a smooth surface of yellow-red or bright red color. In some cases, a bloody or serous crust appears on the surfaces of erosions. If you remove it, the opened wound bleeds a little. Touching erosions does not cause pain. Once erosion appears, it does not heal for several weeks or months. After disappearing, soon enough new erosions appear in their place or nearby.

Manganotti cheilitis is diagnosed by external examination and questioning of the patient. This disease has symptoms similar to those of herpes, leukoplakia, lichen planus or lupus erythematosus. For differential diagnosis, oncologists scrape the affected area of ​​the lip and send it for a thorough histological examination. This scraping makes it possible to detect emerging cancer cells in a timely manner and prevent the development of a malignant neoplasm of the lip.

Leukoplakia and lip hyperkeratosis

Leukoplakia of the lip is a lesion of the mucous membranes with keratinization of the epithelial tissues. Unfavorable factors that contribute to the development of leukoplakia may be alcohol abuse, smoking and eating very spicy foods. Leukoplakias of the lower lip most often develop in the mucous membranes at the corners of the mouth.

Hyperkeratosis of the lips appears as a limited area from 0.2 to 1 cm in diameter. Its surface is smooth, covered with thin, tightly packed grayish-white scales. Scraping cannot remove them.

Diagnostics

In order to more reliably determine whether the neoplasm belongs to anogenital warts, a test is carried out with a 5% solution of acetic acid, after treatment with which papillomas in intimate places retain a grayish-white color with a changing, intensifying vascular pattern of normal skin. Laboratory tests can also be used in diagnosis - identification of the HPV genotype with a prognosis for the course of the disease.

To diagnose precancerous conditions against the background of papillomas in intimate places in women, consultation with an obstetrician-gynecologist and urologist is recommended when papillomas are localized in intimate places in men, for example, with intraurethral localization. If there are papillomatous processes in the anal area, consultation with a proctologist is recommended.

Symptoms of lip cancer

There are local and general signs of lip cancer. Local symptoms of a malignant neoplasm can often be seen on the lower lip. When the pathological process is located on the mucous membrane of the lips, facing the vestibule of the mouth, the tumor has a pronounced malignancy. General signs of lip cancer can develop if the tumor is not detected in a timely manner and treated inadequately in the later stages of cancer.

First symptoms

The first signs of lip cancer usually go unnoticed. First, you can determine the enlargement of the mental lymph nodes. You can notice this by feeling the lower jaw. The next early sign of lip cancer is a swelling of a dense consistency. Itching occurs in it. This neoplasm is usually mistaken for a herpetic rash.

A small ulcer with a crust forms in the center of the swelling, which does not cause pain. If it is removed, the patient feels quite severe pain, and upon closer inspection, he may find a bleeding base, which is formed by tubercles.

Local signs of tumor

Symptoms of lip cancer are:

• Dyskeratosis of the lips;
• Papilloma;
• Erosion;
• Cheilitis.

In most cases, dyskateriosis looks like cracks and ulcers. The erosions are covered with a crust and resemble herpes in appearance, but, unlike it, they do not heal after a certain period of time. Some patients have no ulcers or erosions. Instead, a small compaction appears, which over time grows and becomes covered with a crust.

On the red border of the lower lip, away from the midline, a patch or formation may appear that protrudes above the surface. An erosion or ulcer with a granular surface and a roll-like edge forms in the center of the tumor. The formation has a dense consistency and gradually increases in size, eventually acquiring an irregular shape. Its boundaries are unclear.

Exophytic lip cancer predominantly develops from a warty form of productive diffuse dyskeratosis of papilloma. With exophytic growth, the tumor has a dense consistency, often covered with flat scales. Endophytic growth of a cancerous tumor is characterized by the formation of an ulcer with uneven, dense edges. It often appears against the background of destructive dyskeratosis, quickly infiltrates the soft tissues of the lip and is prone to metastasis.

Symptoms of the disease should be a signal to immediately contact oncologists at the Yusupov Hospital. Lip cancer, treatment of which is started on time, is completely cured in 90% of cases.

What warts can lead to cancer? Let's discuss it with a dermatologist

Not long ago we wrote a detailed article about the types of warts and methods of treating them, you can read this link. In today’s article, we will look at the myths about warts and ask dermatovenerologist Oleg Vladimirovich Demchenko from the Moscow MC “Health” about which of them can still lead to cancer.

— Oleg Vladimirovich, is it true that warts are a precancer?

No, this is not true, and such a question has never faced doctors. Such information is distributed on the Internet without going into detail, often in order to sell a person some kind of miraculous ointment. In fact, we know that warts, or papillomas, are caused by different strains of human papillomaviruses - some of them have a high oncogenic risk, others have almost zero.

— That is, if a person has HPV, then he is at risk?

More than half of the world's population is infected with HPV. Some people live their whole lives without even noticing it, because the immune system suppresses the virus. But if immunity decreases, a person develops those same notorious warts in different parts of the body. If you have them, it makes sense to consult a doctor and get tested for HPV strains. There are a number of the most dangerous strains - 16, 18, 30, 31, 33, 39, 40, 42, 43, 52, 55, 57-59, 61, 62 and 67-70. They have an extremely high oncogenic risk. For example, 90% of malignant tumors of the oropharynx, cervix and anal canal are caused by strains 16 and 18.

— Does it happen that the strain is low-oncogenic, but a tumor has formed that is malignant?

This happens, but very rarely. In any case, a wart is a reason to make an appointment with a doctor and get checked.

— Are there
any types of warts that still indicate oncology?
Even if indirectly. Yes, these are papillomas in the nasopharynx, mammary glands, genitals and anal canal. You can’t delay with such warts. It is necessary to undergo an examination as soon as possible, eliminate the risk of malignancy and remove the resulting papillomas.

— Maybe it’s easier to buy
some ointment and cure it at home?
This is the first time I’ve heard that ointments reduce the risk of cancer. But medicine knows about the development of chemically induced tumors as a result of the use of all kinds of dubious sprays, ointments and creams. It's not worth the risk.

- They say warts can go away on their own...

This actually happens if an HPV outbreak was simply triggered by a decrease in a person’s immunity. Warts on the hands and feet sometimes disappear as a result of improved immunity and hygiene. This happens often in children, for example. The body returns to stable functioning, strong immunity suppresses the virus. But this cannot be predicted. If you have papillomas, you cannot be sure whether they will disappear over time or will begin to spread and grow at a rapid rate. In our country, people don’t like to go to the hospital; they wait for it to go away on its own, so we, doctors, sometimes encounter advanced cases. Patients come when papillomas prevent them from walking (in the case of growth on the feet) or living a full sexual life (in the case of developing genital warts on the genitals).

— Can you recommend
any preventative measures?
First of all, a healthy lifestyle and maintaining immunity in all seasons. Taking care of body hygiene, contraception during sexual intercourse. And, of course, timely consultation with a doctor in case of papillomas. We need to overcome our fear of hospitals and doctors. Health should come first!

Not every wart will turn into cancer, so you shouldn’t believe loud headlines and buy dubious drugs and ointments on the Internet. Recently, cancerophobia has been developing in the world - the fear of developing cancer. People begin to see cancer in any symptom, which leads to the development of neuroses rather than to oncology.

Listen to the advice of doctors, undergo a full annual examination to exclude the development of chronic diseases, including oncology. In the network of Moscow MCs “Health”, doctors are ready to see you - therapists, gynecologists, urologists, surgeons, physiotherapists, cardiologists, dentists and other specialists. You can take tests and undergo a full examination if symptoms that concern you arise.

Be healthy!

Stages

Currently, the generally accepted classification of lip cancer is TNM (T-size of the tumor, N-damage to the lymph nodes, M-metastases). Based on the size of the tumor, there are 4 stages of lip cancer.

Table 1. Stages of lip cancer

If on the affected side there are single enlarged lymph nodes, the size of which is less than 3 cm, this is stage N1 lip cancer. At stage N2, enlarged lymph nodes are detected on the affected side, the diameter of which is more than 3 cm. If the patient has single enlarged lymph nodes on the affected side measuring 3-6 cm in size, this is stage N2a of lip cancer. At stage N2, oncologists determine multiple metastases to the lymph nodes. Their size is equal to or greater than 6cm. In the presence of bilateral metastases in the lymph nodes measuring 6 centimeters, they speak of the N2c stage of lip cancer. If the diameter of the lymph nodes exceeds 6 cm, this is stage N3 of the disease.

In the absence of distant metastases, oncologists determine stage M0 of lip cancer, if there are distant metastases - M1, in the case of distant metastases that cannot be assessed - MX. The diagnosis of “early stage lip cancer” is made in the presence of a tumor less than or equal to 2 cm, the presence of single enlarged lymph nodes less than 3 cm on the affected side and the absence of distant metastases. This is T1 N1 M0.

Types of warts and specific symptoms:

1. Molluscum contagiosum
   . Localization - on the body or in the genital area. There are depressed areas on the surface. If you press on the wart, a mushy substance may begin to ooze.
2. Nevi
   . May be a congenital problem, raised significantly above the surface of the skin. Characterized by a dark brown color, as well as the presence of hair.
3. Basalioma
   . It has a crust on the surface; if it is removed intentionally or accidentally, bleeding begins.

Diagnosis of a tumor by a doctor in a hospital

What does lip cancer look like? It could be a small ulcer or a widespread tumor. Doctors at the Oncology Clinic of the Yusupov Hospital make a diagnosis of lip cancer based on the patient’s complaints, the results of an external examination and additional studies. The oncologist carefully examines and palpates the lips, cheeks, gums and regional lymph nodes. When examining the red border of the lips, skin and mucous membrane, use a magnifying glass.

How to identify lip cancer? Further examination is carried out using instrumental and laboratory diagnostic methods:

• Ultrasound examination;
• X-rays of the lower jaw;
• Panoramic tomography;
• Cytological examination of material obtained by taking fingerprint smears from the surface of the ulcer or histological examination of tissue obtained during a biopsy.

For lip cancer with lymphatic metastasis, a biopsy of the lymph nodes is performed. To exclude hematogenous metastases, chest X-ray and ultrasound examination of the abdominal organs are used. When the diagnosis of lip cancer is confirmed, an X-ray examination of the chest organs, general clinical and laboratory examination (electrocardiography, blood and urine tests) are performed.

A PET-CT study (positron emission computed tomography) is prescribed for the following purposes:

• Determining the stage of lip cancer;
• Assessment of response to treatment;
• Detection of disease relapse during the observation period.

PET-CT is an innovative method that combines the capabilities of computer technology and radiology. At the Yusupov Hospital, it is used not only to diagnose lip cancer, but also to monitor tumor development and evaluate the outcome of treatment. Thanks to PET-CT, radiologists have the opportunity to very accurately carry out radiation treatment, significantly reduce the irradiation area, and minimize the impact on healthy organs and tissues.

In many cases, the use of PET-CT excludes a number of additional studies in the future. This allows patients of the Yusupov Hospital to save time and money. The issue of the need to use this method is decided individually for a specific patient at a meeting of the expert council with the participation of professors and doctors of the highest category. A comprehensive examination of patients using the latest diagnostic equipment, the use of modern methods of performing laboratory tests using high-quality reagents allows oncologists at the Yusupov Hospital to obtain reliable results and provide adequate therapy for lip cancer at an early stage.

Wart removal in the clinic

The clinic uses modern hardware techniques to excise growths:

1. Laser therapy . The method allows you to quickly and without blood remove the growth. There is no discomfort during the procedure, as pain relief is performed. During one session, you can get rid of several tumors in a very short time. The method is suitable not only for adults, but also for children. The likelihood of relapse is minimized. Skin defects in the form of scars after laser use are very rare.

1. Radio wave therapy . The technique is considered the safest. When excising a wart using a radio wave, there is no contact with the skin. It is not always possible to completely remove the growth. The procedure leaves no traces of impact.
2. Electrocoagulation . The procedure requires anesthesia. Using an electrode to which a high-frequency electric current is applied, the wart is burned out, followed by cutting off the growth with a special metal loop. Scarring may appear after removal.
3. Cryodestruction . Liquid nitrogen is used and the wart is treated until it turns white. As a result of exposure to low temperatures, the growth tissues die. There is no need for anesthesia for the manipulation. The disadvantage of the technique is the lack of control over the depth of nitrogen exposure. For this reason, frequent relapses occur.
4. Surgical. Removal is done using a scalpel. The disadvantage of the procedure is the formation of a scar, so this technique is used only for certain indications (in case of malignancy of the process and large size of the wart).

Treatment of lip cancer

How to treat lip cancer? When treating the disease, oncologists at the Yusupov Hospital take into account many different factors: the patient’s age, histological type of tumor, features of the spread of the tumor. Doctors at the Oncology Clinic provide multidisciplinary treatment for lip cancer:

• Surgical interventions;
• Radiotherapy;
• Chemotherapy.

Regardless of the chosen technique, they affect the lesion or tumor, areas of regional metastasis. For grades I and II of lip cancer, radiation treatment is performed, which includes external radiotherapy and surgery.

Treatment in the initial stages

Squamous cell carcinoma of the lower lip is a common complex tumor process. Its treatment consists of two stages: removal of the main focus and the fight against metastases that have spread to neighboring tissues and organs. Radiation treatment can suppress the development of a tumor focus. The radiologist selects the method of radiation therapy individually, depending on the size of the tumor, stage of the disease, and age of the patient.

Removal using the Krail method

In the initial stage of the tumor, surgeons perform a wedge-shaped excision of the entire thickness of the lip under local anesthesia. In order to remove a defect on the lip, plastic surgery is performed - skin flaps are transferred from the patient's cheek. Removal of the lesion is performed using the Krail technique. The operation is performed at the first and second stages of lip cancer, when the tumor has not spread to nearby tissues. Surgical excision of carcinoma makes sense in the absence of metastases.

The decision to remove a lymph node is made by an oncologist surgeon if the primary tumor process has already been cured or if the lymph node is removed along with the removal of the main lesion. In some cases, surgeons remove the primary cancerous tumor, the affected lymph nodes and the vessels that connect them. The scope of the operation is determined collectively by the clinic's oncologists.

Due to the fact that metastasis can occur in a cross way, the lymphatic apparatus of the suprahyoid region on the left and right is removed. If the oncologist sees that there are cancer metastases in certain lymph nodes, he decides to remove them, and those that are located along the lymph outflow.

Treatment tactics for lip cancer depend on the stage of the disease:

• Preventive surgery at stages I and II of lip cancer is carried out exclusively in cases where it is not possible to control the dynamics of the disease and there are unfavorable prognoses regarding the spread of cancer;
• At stage III, in the absence of metastases, treatment is carried out using a combined effect on the lesion and adjacent areas;
• In case of spread of cancer cells and the presence of single metastases in the lymph nodes, oncologists at the Yusupov Hospital perform combined treatment of lip cancer with subsequent surgery, plastic surgery and surgical correction of the lips;
• In stage IVC, palliative chemoradiotherapy is performed.

Candidates and doctors of medical sciences use innovative methods of treating lip cancer. The presence of modern equipment and competent medical personnel who are attentive to all the wishes of patients allows us to achieve good results in the treatment of lip cancer for many years. Lip cancer, treated in the early stages, is cured in 97-100% of cases. At stage III, 67-80% of patients can be cured. In the fourth stage of cancer and repeated relapses, complete recovery occurs in 55% of cases.

Is it necessary to remove a wart on the lip?

Removal of the tumor is carried out if there are indications for this.

The growths sometimes disappear spontaneously.

Therefore, if the wart is small and does not cause much concern, then there is no need for removal.

The decision to excise the growth must be made by a specialist.

If a wart causes discomfort in the form of itching, burning, pain, grows, becomes inflamed, or changes in appearance.

If it has increased in size, changed shape and color, or is bleeding, then it must be removed by resorting to excision by one of the methods.

Removing a tumor at home is not safe.

As a result of incorrect actions:

• It may not be possible to remove the wart completely, which will cause its reappearance
• the risk of injury to healthy tissues that surround the growth increases
• scars and cicatrices may form

Prevention

There are primary and secondary prevention of lip cancer. Oncologists recommend:

• Take precautions when exposed to the sun (wear a wide-brimmed hat);
• Stop smoking pipes and cigarettes;
• Maintain oral hygiene;
• Change working conditions;
• Do not drink strong alcoholic drinks.

For persons prone to dyskeratosis of the lips and cheilitis, oncologists at the Yusupov Hospital conduct an annual preventive examination. Secondary prevention of lip cancer consists of regular dental treatment at the dentist, surgical intervention in the presence of dyskeratosis and cheilitis.

Lip cancer: treatment at Yusupov Hospital

Effective treatment of lip cancer in Moscow is carried out by doctors from the oncology clinic of the Yusupov Hospital. Oncologists have many years of experience in treating malignant neoplasms of the lip. Surgeons are fluent in surgical techniques. The cost of surgery is lower than in other oncology clinics in Moscow, despite the high level of qualifications of doctors and modern equipment.

Radiotherapy is carried out using modern radiation installations from leading European and American manufacturers. In order to undergo a course of effective treatment for lip cancer at an affordable price, call the Yusupov Hospital. After the operation, surgeons at the Oncology Clinic perform lip plastic surgery using innovative surgical techniques.