Medical Certificate Following Colon Cancer

[Anonymous Cancer Survivor]

I am a male in my 40s currently being treated for colon cancer, who has previously held a medical certificate. I had a successful surgical resection, with no ostomy required and a return of normal bathroom function (the tumor was in the right colon). The pathology staging is Stage II (T3N0), but because of extramural vascular invasion, I am currently going through a three-month course of CAPOX chemotherapy (capecitabine plus oxaliplatin). There is no evidence of metastasis on CT, CEA has never been elevated, and pre-chemotherapy ctDNA testing shows no detectable circulating tumor DNA.

Let’s assume that I do the normal follow-up testing (according to NCCN guidelines) plus ctDNA screening, and never see evidence of recurrent disease (fingers crossed for that!). BasicMed is an option for me, and very possibly the correct option, but there are reasons I would prefer a normal medical certificate.

Am I correct that five years after completion of chemotherapy I can apply for a medical certificate without special issuance? Am I correct that CACI is never going to be an option because of the chemotherapy? Prior to five years, how hard is it going to be to get a special issuance? How soon after completion of chemotherapy could I apply? Is the FAA going to ask for any testing beyond normal standard-of-care pathology and follow-up testing?

Any informed advice would be greatly appreciated.

 

[Clip4]

Ever hear of Basic Med?


§ 68.9 Special Issuance process.
(a) General. An individual who has met the qualifications to operate an aircraft under § 61.113(i) of this chapter and is seeking to act as a pilot in command or serve as a required flightcrew member under that section must have completed the process for obtaining an Authorization for Special Issuance of a Medical Certificate for each of the following:

(1) A mental health disorder, limited to an established medical history or clinical diagnosis of -

(i) A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;

(ii) A psychosis, defined as a case in which an individual -

(A) Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or

(B) May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;

(iii) A bipolar disorder; or

(iv) A substance dependence within the previous 2 years, as defined in § 67.307(a)(4) of this chapter.

(2) A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:

(i) Epilepsy;

(ii) Disturbance of consciousness without satisfactory medical explanation of the cause; or

(iii) A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.

(3) A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:

(i) Myocardial infarction;

(ii) Coronary heart disease that has required treatment;

(iii) Cardiac valve replacement; or

(iv) Heart replacement

 

[kath]

Ever hear of Basic Med?

If you read the OP's post, he or she clearly has heard of BasicMed, and knows that it's a good option, but is asking the question anyway.

OP: Greetings, and welcome to the Survivors Club!

My chemotherapy ended in May of 2021, and I am waiting for the 5-year clock to run out before thinking about possibly getting a regular medical. BasicMed was so so so easy by comparison (as everyone will want to point out).

I don't really understand what the 5-year thing represents exactly either. I can tell you that the AME who did my BasicMed suggested that getting a regular medical was totally possible ("cancer isn't disqualifying" were his exact words), and that it would involve "just some extra paperwork that might take a few months." Since I was only in the office for BasicMed, I didn't inquire further than this at the time (umm... what kind of paperwork?). But given that BasicMed effectively strands me here in Alaska (unable to go through Canada), I have often wondered about this exact question myself, and so I hope that some experts can chime in with an answer.

So I don't have any answers; I hope I can learn too. But I did want to jump in and wish you a happy healing. My chemo was once a week for six months. I actually looked forward to infusion day -- I would turn my phone off, and leave all my work and worldly stresses behind, and tell myself that the day was entirely for self-care.
All the best!

 

[WingmanMed]

This article answers most of your questions.

Yes, after 5 years you shouldn't need an SI if you meet the requirements.
Correct, you won't meet CACI because you had high risk features (invasion and chemo).
How hard? That all depends on how well you are doing and how good your documentation is.
How soon after? When you have fully stabilized back to baseline, and with the approval of your treating physician, is a good time to apply. BUT you'll want to be prepared with good documentation first.

 

[bbchien]

Do basic med, in the interim!!