Any other pilots? Are you grounded post prostatectomy?

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aviator
Regular Member


Date Joined Jun 2007
Total Posts : 22
   Posted 6/9/2007 5:13 AM (GMT -6)   
I've found various spins on this topic, and am curious if there are other pilots here who have had experience with the FAA with respect to prostate cancer.  On the one hand, it's apparent that re-issuance of a medical certificate requires extensive documentation that you are free of disease.  On the other hand, if your medical is current, I don't see any way that it falls under the conditions that would require self grounding.
 
I certainly feel fit to fly (almost 2 weeks post op), am not taking any pain meds, and can easily wait 6 hours after taking a small dose of Viagra.  I flew a J3 yesterday, but could do that under the sport pilot certificate anyway.

Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 6/9/2007 11:57 AM (GMT -6)   

Think Jetguy can help. Will bump Bluebirds "Helpful Hints" thread so you can find his posts. 

Dutch



Diagnosed Feb 2001  (Age 65)  Currently 71
PSA 4.8
Gleason 3 + 3 = 6
T2b
Completed Proton therapy @ Loma Linda - Aug 2001
5yr PSA   0.17
Have had no side effects.

Post Edited (Dutch) : 6/9/2007 5:31:21 PM (GMT-6)


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 6/9/2007 11:18 PM (GMT -6)   

Hey Aviator, I'm also a pilot and have just come home from the races and am tired.  Will talk to you tomorrow.  The sad truth is that your FAA medical certifcate is not valid at this time. I got my first class back and you can too, but there are things to do.  Have fun in the Cub. 

Regards,

Bill


Gleason 3+3=6, T1c, one core in twelve, another pre-cancerous.
62 years old and good health.  Married 37 years.  To same woman!
Began IGRT January 23, 2007. 


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 6/10/2007 4:14 PM (GMT -6)   

To offer a little more information for you, aviator.  Please understand that what I offer is my experience only.  I'm not the Feds.

1.  Your medical certificate is no longer valid.

2.  You must submit info on your diagnosis, treatment, outcome, and (maybe) PSA to your regional FAA hdqtrs (or OK City).  If the Feds like what you send them, they will issue a Special Issuance permission for your AME to do the exam and issue you a medical certificate.  You will need to check with your AME about specifics for your region as they are not all the same.

3.  I am required to submit a PSA in November and take another exam.  Then in May 2008 and each year thereafter I must submit a letter from my treating Urologist when I go for my exam.  The letter I have from the Feds is good for 6 years.  I don't know what happens after that.

I'm certain  you are aware that if you are denied a Medical Certificate, you are no longer Sport Pilot eligible.  I recommend you not take it till you know you can pass it.  Just my two cents worth.

Good Luck to You,

Bill


Gleason 3+3=6, T1c, one core in twelve, another pre-cancerous.
62 years old and good health.  Married 37 years.  To same woman!
Began IGRT January 23, 2007. 


aviator
Regular Member


Date Joined Jun 2007
Total Posts : 22
   Posted 6/10/2007 5:24 PM (GMT -6)   

Thanks, Bill.  I've gotten a fairly good idea about the hoops to go through before going for a new medical exam (and the need to avoid a rejection to fly LSA), but my uncertainty comes from #1, above, i.e. that my medical certificate is no longer valid.  Cancer (of any kind) is not one of the 15 or 16 conditions listed that require immediate self grounding.  I don't have a condition that renders me unable to perform the duties required to exercise the priveleges, blah,blah...., and I don't know that I have a condition that would prevent me from meeting the requirements to pass a medical exam.

I realize that it's the last statement that's the sticky one.  In the absence of metastatic disease pilots are able to pass the medical exam.  As far as I'm concerned, the cancer is gone and I have no metastatic disease.  Sure, I [b]might[/b] have mets, but I might also have diabetes or kidney stones that I don't know about at this point, but I don't have to prove it during the valid time period of my current medical.  I will at the next exam, but I'm OK to fly in the meantime as long as I don't "know or have reason to know" of those conditions.Here's the clip from the AOPA site:

 

A: "Although not one of the specifically disqualifying medical conditions reference in Part 67 of the FARs, a report of prostate cancer on the medical application will require additional documentation before the aviation medical examiner can issue a certificate. At the time of the FAA examination, you will need all medical records pertaining to the treatment of the malignancy. This includes admission history and physical reports, surgical reports, pathology reports, discharge summary, and a current, detailed status report from your treating physician. If the records show no evidence of matastasis (spread) of the tumor to other organs, completion of all treatment with no adverse side effects, and a favorable prognosis, the AME, with the approval of the Regional Flight Surgeon or the FAA in Oklahoma City, may issue a medical certificate at the time of examination. Our medical certification has a subject report."

Doesn't that make it sound as if you're OK to fly between exams, unless you know you have metastatic disease?

 

"



jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 6/11/2007 6:17 PM (GMT -6)   

Aviator, I lack the knowledge to answer your question.  I am a corporate pilot and we have a contract with a specialty aviation medical service.  Once I began treatment I was told that I was medically unfit to fly.  The letter I got from the Feds said that I was no longer able to hold an FAA flight physical except by Special Issuance.  We have always sort of 'self certified' haven't we?  If you have a current Medical Certificate and you are sick, you don't fly.  You have 'self certfied' that at this time, you shouln't be flying. 

I think you have a strong point, but it's your decision.  As a professional pilot with a responsiblity to my company, my peers, and my passengers, I wouldn't fly. As a Private Pilot, I would make my decision as you must make yours.  (I hope that was so vague as to be incomprehensible.)  : )

"Maintain thy airspeed. lest the earth shall rise up an smite thee."

Bill


Gleason 3+3=6, T1c, one core in twelve, another pre-cancerous.
62 years old and good health.  Married 37 years.  To same woman!
Began IGRT January 23, 2007. 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 6/11/2007 7:11 PM (GMT -6)   
Hey Preacher Bill,

You quote about airspeed has me rolling on the floor!!!  The same thing can be said about riding a motorcycle.

Jim


Age 72. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2B. Gleason 3+4. Cancer confined to prostate.
PSA on 1/3/07 - 0.04. 
PSA on 4/4/07 - 0.00  T level - 48  Restarted T therapy.
Next PSA on 7/18/07.
 
 "I have cancer but cancer does not have me."


aviator
Regular Member


Date Joined Jun 2007
Total Posts : 22
   Posted 6/11/2007 8:16 PM (GMT -6)   
jetguy said...

Aviator, I lack the knowledge to answer your question.  I am a corporate pilot and we have a contract with a specialty aviation medical service.  Once I began treatment I was told that I was medically unfit to fly.  The letter I got from the Feds said that I was no longer able to hold an FAA flight physical except by Special Issuance.  We have always sort of 'self certified' haven't we?  If you have a current Medical Certificate and you are sick, you don't fly.  You have 'self certfied' that at this time, you shouln't be flying. 

I think you have a strong point, but it's your decision.  As a professional pilot with a responsiblity to my company, my peers, and my passengers, I wouldn't fly. As a Private Pilot, I would make my decision as you must make yours.  (I hope that was so vague as to be incomprehensible.)  : )

"Maintain thy airspeed. lest the earth shall rise up an smite thee."

Bill

You're right, I think.  And it's probably more of an insurance issue than anything, and that only applies if there is a claim of some kind, which is unlikely.  I have mailed to my urologist a copy of the AOPA web site statement, and I've also given him the part 67 applicable regulations, and asked him to  initial it to document that he has read it and advised me that in his opinion I'm fit to fly, which I really believe I am.
 
The idiocy of this whole concept is that someone with complete removal of the prostate, with clear margins and no clinical evidence of metastatic disease (and who has completely recovered from the surgery) is somehow so likely to have sudden incapacitating symptoms related to it that he should be grounded until it's  "proven" that he doesn't have metastatic disease, which of course you can not "prove" in anybody. 


N4529K
New Member


Date Joined May 2010
Total Posts : 3
   Posted 5/23/2010 9:04 AM (GMT -6)   
Does anyone have copies of samples for the letters or reports from their doctors?
 
I was diagnosed in April by my urologist (biopsy) and completed treatment (cyberknife) by uncologist in May. Gleason of 6 early stage.
 
Neither seems to have done the paperwork for the FAA before and are looking for a sample letter.
 
Thanks

N4529K
New Member


Date Joined May 2010
Total Posts : 3
   Posted 5/23/2010 10:06 AM (GMT -6)   
Yes while I am sure that may be your sentiment (and often justified) it seems conterproductive and not likely to get my special issue medical sent with any great amount of speed, therefore I think I will simply comply with their (probably unreasonable) requests and forward the necessary documentation. If anyone has a sample doctor's letter/report (preferably one in a form they have accepted and issues a medical on) I would appreciate it
 
Thanks
 
Rich

jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 5/23/2010 11:13 AM (GMT -6)   
The letter from my urologist says:
 
To Whom It May Concern,
 
Please be advised that the above referenced patient's most recent PSA level dated 3/16/10 is ___._.  The patient has no evidence of recurring or persistent carcinoma of the prostate.
 
Sincerely,
 
 
 
Hope that helps.  The FAA will issue you a Special Issuance certificate.
 
Regards,
 
Bill

(The Feds initially wanted much more information, but I just sent all my stuff to the company that handles our medical issues and they took care of it.  VirtualFlightSurgeons.com   The brief letter above has sufficed since.


I first came here in fall of 2006.  Did radiation.  Am fine.

Post Edited (jetguy) : 5/23/2010 11:30:13 AM (GMT-6)


Gleason7
Regular Member


Date Joined Feb 2010
Total Posts : 111
   Posted 5/23/2010 2:37 PM (GMT -6)   
Since you mentioned a J3 I'm assuming you hold a 3rd class medical which does not recognize cancer as an issue that would keep you from flying. Check out this link:

http://www.aviationwise.org/faamedical.html

74 years old....PSA 6.7 - 106 gram big fella - Gleason 3+4+7 - Vatikutti robotic prostatecomy Henry Ford 02/10/10 - confirmed 3+4=7 - margins clear, nerves spared, lymph nodes and vesicles clear. Five week PSA undetectable, no nighttime pads about one month, no daytime pads about 10 weeks (didn't keep a record)......An occasional dibble if I lift, sneeze, etc. but certainly not enough to warrant a pad! Even gave up on pads away from home at about 11 weeks. Can't say enough great things about my surgeon Dr. Peabody....My very large prostate required additional time to make the bladder urethra reconnect with the total procedure taking four hours.

Shaheen10
New Member


Date Joined May 2010
Total Posts : 17
   Posted 6/3/2010 2:02 AM (GMT -6)   
I am also in the same boat. I was Dx with pca in April( what a bad month), and in process of deciding on treatment option. Medical coming up in Oct, and I agree with Aviator, there is really no reason we shouldn't be able to fly as private general aviation pilot. But I also agree with jetguy, reading AOPA and AIM, also the medical exam form we fill out, we have to let FAA know of all conditions that has evolved since last examination. If you put down PCa, the medical examiner has to defer your case to OK City, and you might as well tear up your medical certificate, the folks at OK city are too darn behind that it will take as a minimum 6 months before they get to you and then most likely they want you to be at least few months post operation. Special issuance is pain in the butt. My former boss had to go through it due to heart attack several years ago. Finally he gave up and bought a Er coupe followed by a cub.

The way I see it we have three choices 1) not report and risk revocation of the certificate when they find out. 2) Report and put up with the agony and BS every year, assuming we get the special issuance, 3) let it expire , fly light sport, while finishing up the treatment and then go and apply for the certificate again. Mean time one could sneak once in a while and fly, but if you rent the club will ask for your medical, and if you own your own aircraft, insurance company will ask for it. One solution is probably incorporating the aircraft and just buy hull insurance. I may have to give up my V tail, and end up with some kind of LSA.

If anyone has gone through this procedure within the last 12 months, please share your experience

CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 6/3/2010 10:37 PM (GMT -6)   
I had robotic surgery, can my case was deferred to OK. However, I had to wait weeks, not months, for a special issuance of my 3rd class medical. The yearly requirements are not that stringent, needing only a recent PSA test. The AME only needs to defer if a) PSA rises 0.75ng/ml per year, b) new treatment is initiated, or c) any metastasis occurs.

CaPCa
Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.

08/21/07: Diagnosed with T1c cancer

1 of 12 biopsy cores positive; 10% tissue

Gleason score: 3+3=6

PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)

10/19/07: da Vinci prostatectomy by Dr. Vipul Patel

Difficult surgery due to prostate inflammation.

Both nerve bundles spared.

Spongy erections began within 24hrs of surgery!

10/24/07: Catheter out; down to 1 Serenity pad/day next day.

Final pathology: neg margins, no capsular penetration,

Gleason 3+3=6, 5% tumor involvement, multi-focal.

11/04/07 First usable erection with Cialis

11/22/07 Thanksgiving - Bye-bye, pads

01/17/08 First post-surgery PSA result: < 0.008 ng/ml

03/17/08 Erection quality mostly back to pre-surgery levels with Cialis;

have not tried without meds yet.

04/23/08 Second post-surgery PSA result: < 0.008 ng/ml

07/30/08 Third PSA: 0.01 ng/ml

11/04/08 One year PSA: 0.01

Still taking 10mg Cialis every other day - enjoying the results

too much to stop yet.

02/07/09 Taking 5mg Cialis every other day - having too much fun to try

to stop for now.

03/23/09 PSA: 0.02

10/19/09 PSA: < 0.1 (switched to "standard" assay)
05/06/10 <0.1

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