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T stage 4

T stage 4 cancer of the larynx is also called locally advanced cancer.

Doctors use the ‘T’ part of the TNM system to stage cancer of the larynx. They call this the T stage. The T stage refers to how far your cancer has spread within the larynx and surrounding tissue.

The exact T staging of laryngeal cancer varies. It depends on which part of your larynx the cancer started in. Cancer can start:

  • above the vocal cords (supraglottis)
  • on the vocal cords (glottis)
  • below the vocal cords (subglottis) - this is rare

T stage 4

T stage 4 means the tumour has grown into body tissues outside the larynx. It may have spread to the thyroid gland, windpipe (trachea) or food pipe (oesophagus). 


The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • your type of cancer (the type of cells the cancer started in)
  • where the cancer is 
  • other health conditions that you have

You might be able to have radiotherapy with chemotherapy or a targeted cancer drug. This means you avoid surgery to remove your larynx.

But you might need surgery to remove your whole larynx (laryngectomy) and surrounding lymph nodes, followed by radiotherapy. 

You might have radiotherapy and chemotherapy to shrink your cancer before surgery. Some people may not need surgery after this, so it can be kept in reserve in case the cancer comes back.

Information and help