Kidney cancer
What the FAA's documents say about kidney cancer, in plain words, with the FAA's own words one press away.
FAA term: Renal Cancer
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ANon metastatic, with treatment completed 5 or more years ago. The table's condition for ISSUE is no recurrence or ongoing treatment. | Examiner issues | Examiner can issue |
| Row BNon metastatic, with treatment completed less than 5 years ago. | Worksheet | CACI |
| Row CMetastatic disease, current or any time in the past, or recurrence of disease. | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Kidney cancer
- Row A · Examiner can issue
Non metastatic, with treatment completed 5 or more years ago. The table's condition for ISSUE is no recurrence or ongoing treatment. The table says ISSUE, and has the examiner summarize this history in Block 60.
Non metastatic with treatment completed 5 or more years ago … If no recurrence or ongoing treatment: ISSUE Summarize this history in Block 60.
- Row B · CACI
Non metastatic, with treatment completed less than 5 years ago. The table sends the examiner to the CACI worksheet for renal cancer, and has the examiner note it in Block 60.
Non metastatic with treatment completed less than 5 years ago … Follow CACI worksheet. … Follow the CACI – Renal Cancer Worksheet . Note in Block 60.
- Row C · Special Issuance
Metastatic disease, current or any time in the past, or recurrence of disease. The examiner defers and submits the listed information to the FAA for a possible Special Issuance.
Metastatic disease … Current OR any time in the past … OR … Recurrence of disease … Submit the following to the FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
The FAA pathways for kidney cancer
- How this pathway works: Examiner can issueNo special pathwayRow A
- How this pathway works: CACIConditions AMEs Can IssueRow B
- How this pathway works: Special IssuanceAuthorization for Special Issuance of a Medical CertificateRow C
- How this pathway works: AASIAME Assisted Special IssuanceAfter the FAA decides
Which exam
Your step-by-step plan
Step 1: The progress note from the treating doctor or specialist
The note the examiner reviews before deciding.Within 90 days before the examA current, detailed progress note from a clinic visit with your treating physician or specialist, no more than 90 days before the exam. Your AME reviews it.
Show the FAA's words: The progress note from the treating doctor or specialist
the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam.
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Step 2: The worksheet's criteria
Stability, history, surgery, symptoms, and current treatment.One question insideThe worksheet's box for current treatment is None.
The worksheet's other criteria
- Stable on the current regimen, with no changes recommended by the treating physician
- No symptoms
- Treatment completed and back to full, unrestricted activities (ECOG performance status or equivalent is 0)
No current or historic evidence of
- Not: Chemotherapy
- Not: Disease recurrence
- Not: Extra capsular extension
- Not: Metastatic disease
- Not: Stage 4 disease
- Not: Paraneoplastic syndrome
After surgery
- Off pain medication
- A full recovery
- Released by the surgeon
Show the FAA's words: The worksheet's criteria
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA
Current treatment:
[ ] None
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Treating physician finds the condition stable on current regimen and no changes recommended. [ ] Yes
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Any current or historic evidence of:
Chemotherapy
Disease recurrence;
Extra capsular extension;
Metastatic disease;
Stage 4 disease; or
Paraneoplastic syndrome
[ ] No
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA
Symptoms [ ] No
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Treatment completed and back to full, unrestricted activities (ECOG performance status or equivalent is 0). [ ] Yes
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
If surgery was performed - the airman is off pain medication(s), has made a full recovery, and has been released by the surgeon. [ ] Yes
FAA source: CACI – Renal Cancer Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
The table says ISSUE, and has the examiner summarize this history in Block 60.
Row BWorksheetCACI
The table sends the examiner to the CACI worksheet for renal cancer, and has the examiner note it in Block 60.
Row CDefers to the FAASpecial Issuance
The examiner defers and submits the listed information to the FAA for a possible Special Issuance.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Non metastatic, with treatment completed 5 or more years ago. The table's condition for ISSUE is no recurrence or ongoing treatment. The table says ISSUE, and has the examiner summarize this history in Block 60.
Non metastatic with treatment completed 5 or more years ago … If no recurrence or ongoing treatment: ISSUE Summarize this history in Block 60.
- Row B · CACI
Non metastatic, with treatment completed less than 5 years ago. The table sends the examiner to the CACI worksheet for renal cancer, and has the examiner note it in Block 60.
Non metastatic with treatment completed less than 5 years ago … Follow CACI worksheet. … Follow the CACI – Renal Cancer Worksheet . Note in Block 60.
- Row C · Special Issuance
Metastatic disease, current or any time in the past, or recurrence of disease. The examiner defers and submits the listed information to the FAA for a possible Special Issuance.
Metastatic disease … Current OR any time in the past … OR … Recurrence of disease … Submit the following to the FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
The CACI worksheet's criteria
Your current treatment for renal cancer
The worksheet's other criteria
- Stable on the current regimen, with no changes recommended by the treating physician
- No symptoms
- Treatment completed and back to full, unrestricted activities (ECOG performance status or equivalent is 0)
No current or historic evidence of
- Not: Chemotherapy
- Not: Disease recurrence
- Not: Extra capsular extension
- Not: Metastatic disease
- Not: Stage 4 disease
- Not: Paraneoplastic syndrome
After surgery
- Off pain medication
- A full recovery
- Released by the surgeon
Show the FAA's words: the CACI worksheet's criteria for Kidney cancer
- Stable on the current regimen, with no changes recommended
FAA criterion: the treating physician finds the condition stable on the current regimen, with no changes recommended.
Treating physician finds the condition stable on current regimen and no changes recommended. [ ] Yes
- No current or historic evidence of the six things the worksheet lists
FAA criterion: the worksheet asks whether there is any current or historic evidence of chemotherapy, disease recurrence, extra capsular extension, metastatic disease, stage 4 disease or paraneoplastic syndrome, and the acceptable answer on it is no.
Any current or historic evidence of: … Chemotherapy … Disease recurrence; … Extra capsular extension; … Metastatic disease; … Stage 4 disease; or … Paraneoplastic syndrome … [ ] No
- If surgery was performed, off pain medication, a full recovery and released by the surgeon
FAA criterion, if surgery was performed: the pilot is off pain medication, has made a full recovery, and has been released by the surgeon.
If surgery was performed - the airman is off pain medication(s), has made a full recovery, and has been released by the surgeon. [ ] Yes
- No symptoms
FAA criterion: the worksheet's box for symptoms is No.
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA … Symptoms [ ] No
- Treatment completed and back to full, unrestricted activities
FAA criterion: treatment is completed and the pilot is back to full, unrestricted activities, which the worksheet gives as an ECOG performance status or equivalent of 0.
Treatment completed and back to full, unrestricted activities (ECOG performance status or equivalent is 0). [ ] Yes
If the examiner defersSpecial Issuance
The table's row C is metastatic disease, current or any time in the past, or recurrence of disease, and the table marks it DEFER.
What the FAA lists to send
- Item 1. A current status report from the treating oncologist. The table says it should describe the treatment plan, how long the condition has been stable, the prognosis, and whether any upcoming treatment change is planned or expected.
- Item 2. A list of medications and the presence or absence of side effects, with specific mention of chemotherapy and the dates used.
- Item 3. Treatment records, including clinic notes or a summary letter, describing the initial staging, the disease course, the locations of metastatic disease, and stability.
- Item 4. Operative notes and discharge, if applicable.
- Item 5. Pathology reports, if applicable.
- Item 6. Results of MRI/CT or PET scan reports. The table says that in some cases the actual CDs will be required in DICOM format for FAA review.
- Item 7. Copies of the most recent lab results performed by the treating physician.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table's row C is metastatic disease, current or any time in the past, or recurrence of disease, and the table marks it DEFER.
Metastatic disease … Current OR any time in the past … OR … Recurrence of disease … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current status report from the treating oncologist. The table says it should describe the treatment plan, how long the condition has been stable, the prognosis, and whether any upcoming treatment change is planned or expected.
Current status report from your treating oncologist. It should describe the treatment plan, how long the condition has been stable, prognosis, and if any upcoming treatment change is planned or expected;
- Item 2
A list of medications and the presence or absence of side effects, with specific mention of chemotherapy and the dates used.
List of medications and presence or absence of side effects with specific mention of chemotherapy and dates used;
- Item 3
Treatment records, including clinic notes or a summary letter, describing the initial staging, the disease course, the locations of metastatic disease, and stability.
Treatment records including clinic notes or a summary letter describing initial staging, disease course, locations of metastatic disease, and stability;
- Item 4
Operative notes and discharge, if applicable.
Operative notes and discharge, if applicable;
- Item 5
Pathology reports, if applicable.
Pathology report(s), if applicable;
- Item 6
Results of MRI/CT or PET scan reports. The table says that in some cases the actual CDs will be required in DICOM format for FAA review.
Results of MRI/CT or PET scan reports (In some cases, the actual CDs will be required in DICOM format for FAA review.); and
- Item 7
Copies of the most recent lab results performed by the treating physician.
Copies of most recent lab results performed by your treating physician.
After the FAA decides
AASIAfter a Special Issuance, the table says the follow-up Special Issuance will be per the pilot's own authorization letter. The FAA's AASI sheet for renal cancer says an FAA physician provides the initial certification decision and grants the Authorization, and that for a first-time AASI application, with all the medical information needed for a determination, the examiner must defer and submit all of it to the AMCD or RFS for the initial determination.
Show the FAA's words: after the FAA decides
Followup Special Issuance Will be per the airman's authorization letter
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401 . … If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workAt later examsAASI
- First and second class
- Every year
- Third class
- At each required exam
The worksheet says first- and second-class applicants must provide this information every year, and third-class applicants must provide it with each required exam.
Show the FAA's words: how often the FAA asks again
Applicants for first- or second-class must provide this information annually; applicants for third-class must provide the information with each required exam.
Under an FAA Authorization, the FAA's AASI sheet for renal cancer lists what the pilot provides for the examiner to reissue. That is the Authorization granted by the FAA, and 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 sheet says the Authorization letter comes with attachments that specify the information the treating doctors must provide for the reissue determination.
Show the FAA's words: at later exams
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. … Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: … An Authorization granted by the FAA; and … 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.
What AASI is
AASI stands for AME Assisted Special Issuance. The Guide describes it as a process that lets the examiner reissue a certificate under the provisions of an Authorization for Special Issuance, to an applicant who has a medical condition that is disqualifying under 14 CFR part 67.
How the FAA pathways workThe Authorization granted by the FAA
The AASI sheet's list for a reissue begins with an Authorization granted by the FAA.
Show the FAA's words: The Authorization granted by the FAA
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: … An Authorization granted by the FAA; and
A current status report performed within 90 days
The AASI sheet asks for 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.
Show the FAA's words: A current status report performed within 90 days
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.
What the Authorization letter comes with
The AASI sheet says the Authorization letter comes with attachments that specify the information the treating physicians must provide for the reissue determination.
Show the FAA's words: What the Authorization letter comes with
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
When the examiner defers a reissue
The AASI sheet says the examiner must defer to the AMCD or Region if there has been any recurrence of the cancer, or if any new treatment is initiated.
Show the FAA's words: When the examiner defers a reissue
The Examiner must defer to the AMCD or Region if: … There has been any recurrence of the cancer; or … Any new treatment is initiated.
Good to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
No CACI after 5 years without treatment
If it has been 5 or more years since any treatment for this condition, with no history of metastatic disease and no reoccurrence, the worksheet says CACI is not required. The examiner notes this in Block 60, and the notes point to the disposition table.
Show the FAA's words: good to know, 2
Notes: If it has been 5 or more years since the airman has had any treatment for this condition, with no history of metastatic disease and no reoccurrence, CACI is not required. Note this in Block 60. (See disposition table.)
Chemotherapy is on the worksheet's list
Chemotherapy is on the worksheet's list of things of which there should be no current or historic evidence, beside disease recurrence, extra capsular extension, metastatic disease, stage 4 disease and paraneoplastic syndrome.
Show the FAA's words: good to know, 3
Any current or historic evidence of: … Chemotherapy … Disease recurrence; … Extra capsular extension; … Metastatic disease; … Stage 4 disease; or … Paraneoplastic syndrome … [ ] No
Scan CDs may be required
For the scan reports sent to the FAA on row C, the table says that in some cases the actual CDs will be required in DICOM format for FAA review.
Show the FAA's words: good to know, 4
Results of MRI/CT or PET scan reports (In some cases, the actual CDs will be required in DICOM format for FAA review.); and
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Open to print: CACI – Renal Cancer Worksheet, a PDF at the FAA, in a new tab
- Renal CancerOpen to print: Renal Cancer, a page at the FAA, in a new tab
Examiner can issue, Special Issuance
- Open to print: AASI – Renal Cancer, a page at the FAA, in a new tab
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.