Cancer

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This guidance should be used for applicants with Cancers other than Lymphoid malignancy, Prostate cancer, Melanoma which are covered in specific advice.

Hypoxia - lowers seizure threshold and thus risk from cerebral secondaries
Fatigue and circadian dysentrainment will tend to aggravate any adverse effects of radiotherapy and chemotherapeutic agents

Overt incapacitation
- seizure risk is major hazard
- haemorrhage
Subtle incapacitation
- biochemical and haematological abnormalities (hypercalcaemia, anaemia etc)
- pain
- depression and affective disorders
- medication side-effects (heart, lungs, liver, kidneys, immune competence)

Confirmed diagnosis
History
- Presentation and course of illness including dates
- Assessment for co-morbid disease eg depression
Clinical status (debility, pain, GI symptoms etc)
Grade & stage of malignancy (please include relevant staging investigation reports, scans etc)
Management
Treatment (types and dates of treatment)
- Surgery
- Chemotherapy (curative, adjuvant, palliative) (specify if anthracyclines)
- Radiotherapy (curative, adjuvant, palliative)
- Hormone therapy
Complications of treatment (note investigations or referrals to other specialists)
Follow-up plan
- Frequency of clinical radiological imaging
- Frequency of haematological testing
Ongoing treatment
- Description of specific therapy
Prognosis & Prognostic factors
Risk of possible future recurrence
- What are the likely clinical presentations of recurrence?
- Could this be accompanied by incapacitating symptoms?
- Could a recurrence be detected before symptoms occur by increasing the frequency of radiological, haematological or other surveillance?
References to relevant medical literature

Confirmed diagnosis (any progression or change to diagnosis)
History
Clinical status
- Any evidence of recurrence
- Any evidence of late stage complications of disease or primary treatment
- Assessment for comorbid depression / pain / symptoms
Management (requirement for any additional treatment since initial primary treatment)
Complications of treatment (note investigations or referrals to other specialists)
Prognosis
Risk of possible future recurrence
- What are the likely clinical presentations of recurrence?
- Could this be accompanied by incapacitating symptoms?
- Could a recurrence be detected before symptoms occur by increasing the frequency of radiological, haematological or other surveillance?
Follow-up plan
- Frequency of clinical radiological imaging
- Frequency of haematological testing
References to relevant medical literature

Primary treatment of the disease should be completed before an assessment can be made of a return to flying or controlling.
Adverse prognostic factors will normally lead to a longer period before a return to flying and conversely positive prognostic factors will normally lead to a shorter period before a return to flying or controlling.
A longer time period should normally elapse before returning to flying or controlling after a relapse than is required after primary treatment
Anthracycline therapy requires additional period of surveillance and specialist review
Common time frames for return to flying and controlling duties:
- 6 weeks following completion of radiotherapy
- 2 months following completion of chemotherapy
- 6 months following completion of anthracycline chemotherapy in addition to satisfactory cardiac assessment

The Clinical Practice Guideline is provided by way of guidance only and subject to the Clinical practice guidelines disclaimer