lude Casodex (bicalutamide) and Eulexin (flutamide). Other hormones inhibit the release of hormones that stimulate testosterone. They include Lupron (leuprolide) and Zoladex (goseralen). Usually hormones from each category are given simultaneously. The major side effects include hot flashes and sweating. The FAA will recertify airmen and controllers taking hormones for this condition.
Prostate cancer is the most common cancer in adult men, but is not the most common cause of cancer deaths. Some cases are relatively slow growing and pose little immediate risk to an individual. These cases may not require immediate treatment, but can be followed with careful monitoring. This approach, termed “ Watchful Waiting”, is sometimes recommended in early stages of low grade, slow growing prostate cancer and in older gentlemen. This may reduce the risk of impaired sexual function and loss of bladder control some men experience with other treatments for prostate cancer. Monitoring of the PSA level on a frequent basis is critical for this approach. A rise in the PSA may signal a transition to a more aggressive type of cancer or spread of the cancer.
Again since Apr 2013, AME’s can clear airmen to flying if cancer is confined to prostate. There is some confusion whether or not watchful waiting is included in this policy since it isn’t specially addressed in the Guide to Aviation Medical Examiners. However, the Manager of Aeromedical Certification in Oklahoma City has confirmed that the intent is to allow AMEs to clear watchful waiting as long as cancer is confined to the prostate. Controllers require specific clearance from the Regional Flight Surgeon.
FAA certification after diagnosis of prostate cancer generally requires the operative report and hospital discharge summary (if any), pathology and laboratory reports, the results of any scans or tests for metastatic disease and a statement from the treating physician that the pilot may return to full activity. The physician statement should mention what follow-up evaluations are scheduled and the dosages of any medications.
As of 9 Apr 2013, the FAA modified its policy to allow the Aviation Medical Examiner (AME) to clear airmen with prostate cancer that was confined to the prostate. If spread beyond the prostate, then the case continues to require Special Issuance. This documentation can be submitted directly to the FAA or the AME, but pilots and controllers are cautioned that most clinical specialists are not trained to recognize all of the aeromedically relevant aspects of a case. Erroneous or incomplete information can result in significant delays in certification. Once an airman or controller is returned to duty, the FAA will generally require a Current Status Report from your treating physician at the time of your next FAA medical examination.
AMAS Aeromedical Assistance
For a more specific personal explanation to your questions or those concerning aeromedical certification, contact AMAS for a private consultation. For help in reporting treatment for and obtaining clearance from the FAA to fly or control with these conditions, refer to the AMAS Confidential Questionnaire. If you are an AMAS Corporate Member, these services are FREE to you.