Colon Cancer

Cancer—Colon/Rectal

ColonColorectal cancer is one of the three most frequently diagnosed malignancies in the United States. The majority of colorectal cancers are known as adenocarcinoma; however, other tumors of the large bowel include anal carcinoma, lymphoma, leiomyosarcoma, malignant carcinoid tumor, and Kaposi's sarcoma.

FAA medical certification approval is based, among other things, on the likelihood of sudden incapacitation. Bowel obstruction or perforation may result in sudden incapacitation, while chronic anemia may present a more subtle risk for incapacitation. Undetected disease may result in the cancer spreading to the nervous system and brain, resulting in a seizure or other incapacitating neurological event. For these reasons, the FAA considers a diagnosis of colon cancer to be disqualifying and expects the pilot to self ground under FAR 61.53.

Pilots who have had a colon cancer tumor totally resected (removed surgically) and who have completed all post-operative treatment (radiation or chemotherapy) can be returned to flying status under a special issuance authorization. Permanent and temporary colostomies and ileostomies are acceptable.

However, if the tumor was found to have spread into adjacent lymph nodes, certification will probably not be granted until at least one year after treatment has been completed. Additional testing, including brain MRI, may be required for cancers that were diagnosed at a more advanced stage.

When you're ready to reapply, see your AME for a new flight physical and provide the following records that will be sent to the FAA for review:

Colon cancer:

  • Hospital records, including: admission history and physical, all pre-op diagnostic study reports, operative reports, pathology reports, and discharge summary.
  • Current laboratory blood work including carcinoembryonic antigen and CBC.
  • For more advanced cancers, (Stage III or IV), oncology records including liver function tests, CT, brain MRI, colonoscopy or air contrast barium enema, and serum CEA measurement. Stage IV cancers will probably require three years of observation with no recurrence.
  • A detailed current status report from the treating physician, that includes date diagnosed, type of treatment(s) with start and completion dates, medication information, current condition, and prognosis.

Rectal cancer:

  • Hospital records, including: admission history and physical, all pre-op diagnostic study reports, operative reports, pathology reports, and discharge summary.
  • Current laboratory blood work including CEA (carcinoembryonic antigen) and CBC.

AASI for Colon Cancer

After initial certification by the FAA, subsequent renewals qualify for AME Assisted Special Issuance (AASI), a process that provides examiners the authorization to issue an airman medical certificate to an applicant who has a medical condition that must be certified under a special issuance authorization. Examiners may reissue an airman medical certificate if the applicant provides the following:

  • An authorization letter granted by the FAA.
  • A current status report performed within 90 days that must include all the required follow-up items and studies as listed in the authorization letter and that confirms absence of recurrent disease.

The examiner should defer to the AMCD or Region if there has been any progression of the disease, or the CEA is elevated.

How/Where to Submit to the FAA

Helps you find the contact information for submitting your medical records.

Updated 03/11