Malignant disease

Question 1

What information do you want to know regarding Malignancy

Answer 1

Site
Local effect
Metastasis: site, effects
Systemic effects: metabolic, endocrine, psychological
Effects of treatment
Prognosis
Surveillance requirements

Question 2

What is an ECOG

Answer 2

Eastern cooperative oncology group performance status

Question 3

Malignant disease
Effect of conditions on aviation
Effects of aviation on condition

Answer 3

Condition on aviation

• overtly - sudden incapacitation
• Subclinical - eg reduced reaction times

Aviation on condition
- increased physiological demands
- operational issues
- surveillance needs -  can’t deploy due to follow up etc..
Don’t forget psychological impact

Question 4

Military aeromedical disposition for malignant disease

Answer 4

TMUFF - initial suspicion/diagnosis
MECR - on initial confirmation of diagnosis
- Depends of malignancy and recruit vs trained aircrew

Question 5

Steps to certification after treatment of malignant disease

Answer 5

No consideration of return to primary duties until tx completed, full remission achieved and prognosis determined for BCC/SCC, early prostate cancer, some indolent lymphoid malignancies.

Need ongoing risk of recurrence/incapacitation/deterioration
Most likely site of recurrence/met
Likelihood of incapacitation due to that recurrence/ met
Need wavier

Question 6

CASA perspective of malignancy

Answer 6

Grounded until fitness to return assessed by CASA

Wants to know
Direct effect of the primary tumour
Effect of secondary spread
Effect of treatment modalities
Psychological effect
Cache is
Endocrine or biochemical disturbance
Likely hood of reoccurance and risk of incapacitation