CASA Website > Avmed > Guidelines > Melanoma
Melanoma
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Aeromedical Implications
Effect of aviation on condition
- Hypoxia - lowers seizure threshold and thus risk from cerebral secondaries
- Fatigue and jet lag will tend to aggravate any adverse effects of radiotherapy and chemotherapeutic agents
Effect of condition on aviation
- Overt incapacitation
- seizure risk is major hazard
- Subtle incapacitation
- pain
- depression and affective disorders
- medication side-effects (heart, lungs, liver, kidneys, immune competence)
- Distraction due to treatment & symptoms eg pain and nausea
Approach to medical certification
Based on the condition
- Incapacitation risk
- Risk of metastasis
- Absence of symptoms / complications including psychological
Based on Treatment
Demonstrated Stability
- May include interim surveillance
Risk assessment protocol - Information required
New cases
- Confirmed diagnosis
- Clinical status
- presenting symptoms/signs eg lymphadenopathy
- Investigations conducted
- Results of staging investigations/histology
- Follow-up investigations
- Management
- 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
Renewal
- Current clinical status
- symptoms/signs
- skin check
- lymph node examination
- Investigations conducted
- Follow-up investigations eg skin excisions, imaging/ PET scans, lymph node biopsies
- Management
- 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.
Indicative outcomes
Prognostic data from AJCC may be helpful
Favourable
- Low risk melanoma - confirmed histology and fully excised
Unfavourable
- Metastatic melanoma
- Melanoma with an unacceptable risk of metastasis
- Melanoma requiring radiotherapy or chemotherapy
Pilot & Controller Information
- It is very important to provide the laboratory report about any skin lumps or moles removed. This provides the base information to enable an assessment
- CASA may require annual dermatologist or GP reports for 5 years following treatment for low risk melanoma
- Applicants with unacceptable metastasis risk may not meet the required standard for medical certification
- Multi-crew restriction may be applied in some cases depending on risk of metastasis
Disclaimer
The Clinical Practice Guideline is provided by way of guidance only and subject to the Clinical practice guidelines disclaimer
