Testicular cancer
What the FAA's documents say about testicular cancer, in plain words, with the FAA's own words one press away.
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ANon metastatic, and treatment completed 5 or more years ago. The table's evaluation data is no recurrence or ongoing treatment. | Examiner issues | Examiner can issue |
| Row BNon metastatic, and treatment completed less than 5 years ago. | Worksheet | CACI |
| Row CMetastatic disease, current or anytime in the past, and recurrence of disease. The row prints its last two lines with no OR between them. | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Testicular cancer
- Row A · Examiner can issue
Non metastatic, and treatment completed 5 or more years ago. The table's evaluation data is no recurrence or ongoing treatment. The table says ISSUE, and has the examiner summarize this history in Block 60.
Non metastatic and treatment completed 5 or more years ago … No recurrence or ongoing treatment: ISSUE Summarize this history in Block 60.
- Row B · CACI
Non metastatic, and treatment completed less than 5 years ago. The table sends the examiner to the CACI worksheet for testicular cancer, and has the examiner note it in Block 60.
Non metastatic and treatment completed less than 5 years ago … See CACI worksheet. … Follow the CACI – Testicular Cancer Worksheet Note in Block 60.
- Row C · Special Issuance
Metastatic disease, current or anytime in the past, and recurrence of disease. The row prints its last two lines with no OR between them. The examiner defers and submits the listed information to the FAA for a possible Special Issuance.
Metastatic disease … Current OR anytime in the past Recurrence of disease … Submit the following to the FAA review: … DEFER … Submit the information to the FAA for a possible Special Issuance.
- A note on the table, 1
The table's notes say that if the pilot is currently on radiation or chemotherapy, the treatment course must be completed before medical certification can be considered, that watchful waiting is allowed, and they point to the CACI worksheet.
Notes regarding Testicular Cancer : If the airman is currently on radiation or chemotherapy, the treatment course must be completed before medical certification can be considered. Watchful waiting is allowed. See CACI – Testicular Cancer Worksheet .
The FAA pathways for testicular 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, and what it verifies.Within 90 days before the examOne question insideA 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.
It verifies
- Stable, with no spread or recurrence
- No current or historic evidence of any metastatic disease
- Active treatment (chemotherapy, radiation, etc.) completed, and no new treatment recommended at this time
After surgery
- Off pain medication
- A full recovery
- Released by the surgeon
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 – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
The treating physician’s current, detailed Clinical Progress Note verifies:
Condition is stable with no spread or recurrence;
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
The treating physician’s current, detailed Clinical Progress Note verifies:
There is no current or historic evidence of any metastatic disease;
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
The treating physician’s current, detailed Clinical Progress Note verifies:
Active treatment is completed (chemotherapy/radiation, etc.) and no new treatment is recommended at this time; and
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
The treating physician’s current, detailed Clinical Progress Note verifies:
If surgery has been performed, the airman is off pain medication(s), has made a full recovery, and has been released by the surgeon. [ ] Yes
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
Step 2: The worksheet's criteria
Symptoms, and your current treatment.The worksheet's box for current treatment is None, surveillance or watchful waiting.
The worksheet's other criteria
- No symptoms
If currently on chemo or radiation
Your AME defers the exam.
Show the FAA's words: The worksheet's criteria
Current treatment
[ ] None, surveillance or watchful waiting
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA
Symptoms [ ] None
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 April 2022; checked by Crosscheck 14 October 2026.
If the airman is currently on chemo or radiation treatment, defer the exam. (See disposition table.)
FAA source: CACI – Testicular Cancer Worksheet. FAA date 27 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 testicular 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, and treatment completed 5 or more years ago. The table's evaluation data is no recurrence or ongoing treatment. The table says ISSUE, and has the examiner summarize this history in Block 60.
Non metastatic and treatment completed 5 or more years ago … No recurrence or ongoing treatment: ISSUE Summarize this history in Block 60.
- Row B · CACI
Non metastatic, and treatment completed less than 5 years ago. The table sends the examiner to the CACI worksheet for testicular cancer, and has the examiner note it in Block 60.
Non metastatic and treatment completed less than 5 years ago … See CACI worksheet. … Follow the CACI – Testicular Cancer Worksheet Note in Block 60.
- Row C · Special Issuance
Metastatic disease, current or anytime in the past, and recurrence of disease. The row prints its last two lines with no OR between them. The examiner defers and submits the listed information to the FAA for a possible Special Issuance.
Metastatic disease … Current OR anytime in the past 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
Progress note
It verifies
- Stable, with no spread or recurrence
- No current or historic evidence of any metastatic disease
- Active treatment (chemotherapy, radiation, etc.) completed, and no new treatment recommended at this time
After surgery
- Off pain medication
- A full recovery
- Released by the surgeon
Your current treatment for testicular cancer
The worksheet's other criteria
- No symptoms
If currently on chemo or radiation
Your AME defers the exam.
Show the FAA's words: the CACI worksheet's criteria for Testicular cancer
- Stable, with no spread or recurrence
FAA criterion: the progress note verifies the condition is stable with no spread or recurrence.
The treating physician’s current, detailed Clinical Progress Note verifies: … Condition is stable with no spread or recurrence;
- No current or historic evidence of any metastatic disease
FAA criterion: the progress note verifies there is no current or historic evidence of any metastatic disease.
The treating physician’s current, detailed Clinical Progress Note verifies: … There is no current or historic evidence of any metastatic disease;
- Active treatment completed, and no new treatment recommended
FAA criterion: the progress note verifies active treatment (chemotherapy, radiation, etc.) is completed and no new treatment is recommended at this time.
The treating physician’s current, detailed Clinical Progress Note verifies: … Active treatment is completed (chemotherapy/radiation, etc.) and no new treatment is recommended at this time; and
- If surgery has been performed, off pain medication, a full recovery and released by the surgeon
FAA criterion, if surgery has been performed: the progress note verifies the pilot is off pain medication, has made a full recovery, and has been released by the surgeon.
The treating physician’s current, detailed Clinical Progress Note verifies: … If surgery has been 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 None.
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA … Symptoms [ ] None
- If currently on chemo or radiation treatment
The worksheet's notes say that if the pilot is currently on chemo or radiation treatment, the examiner defers the exam, and they point to the disposition table.
If the airman is currently on chemo or radiation treatment, defer the exam. (See disposition table.)
If the examiner defersSpecial Issuance
The table's row C is metastatic disease, current or anytime in the past, and recurrence of disease. The table marks it DEFER.
The worksheet says that if the pilot is currently on chemo or radiation treatment, the examiner defers the exam. The table's notes say the treatment course must be completed before medical certification can be considered.
What the FAA lists to send
- Item 1. A current status report from the oncologist describing the treatment plan and the prognosis.
- Item 2. A list of medications, with attention to any chemotherapy agents and the dates used.
- Item 3. Treatment records, including clinic notes or a summary letter, describing the disease course and the initial staging.
- Item 4. Operative notes and the discharge summary, if applicable.
- Item 5. Pathology reports, if applicable.
- Item 6. 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. Serum tumor markers results, if applicable.
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 anytime in the past, and recurrence of disease. The table marks it DEFER.
Metastatic disease … Current OR anytime in the past Recurrence of disease … DEFER … Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The worksheet says that if the pilot is currently on chemo or radiation treatment, the examiner defers the exam. The table's notes say the treatment course must be completed before medical certification can be considered.
If the airman is currently on chemo or radiation treatment, defer the exam. (See disposition table.)
If the airman is currently on radiation or chemotherapy, the treatment course must be completed before medical certification can be considered.
What the FAA lists to send
- Item 1
A current status report from the oncologist describing the treatment plan and the prognosis.
Current status report from oncologist describing treatment plan and prognosis;
- Item 2
A list of medications, with attention to any chemotherapy agents and the dates used.
List of medications with attention to any chemotherapy agents and dates used;
- Item 3
Treatment records, including clinic notes or a summary letter, describing the disease course and the initial staging.
Treatment records including clinic notes or summary letter describing disease course and initial staging;
- Item 4
Operative notes and the discharge summary, if applicable.
Operative notes and discharge summary (if applicable);
- Item 5
Pathology reports, if applicable.
Pathology report(s) (if applicable);
- Item 6
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.
MRI/CT or PET scan reports (in some cases, the actual CDs will be required in DICOM format for FAA review); and
- Item 7
Serum tumor markers results, if applicable.
Serum tumor markers results (if applicable).
After the FAA decides
AASIThe FAA's AASI sheet for testicular 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. After that, the sheet says the examiner may reissue under the Authorization when the pilot provides what it lists.
Show the FAA's words: after the FAA decides
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. … Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
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 testicular 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 followup 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 followup 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 followup 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 followup 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.)
Watchful waiting is allowed
The worksheet's box for current treatment reads none, surveillance or watchful waiting, and the table's notes say watchful waiting is allowed.
Show the FAA's words: good to know, 3
Current treatment … [ ] None, surveillance or watchful waiting
Watchful waiting is allowed. See CACI – Testicular Cancer Worksheet .
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
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 – Testicular Cancer Worksheet, a PDF at the FAA, in a new tab
- Testicular CancerOpen to print: Testicular Cancer, a page at the FAA, in a new tab
Examiner can issue, Special Issuance
- Open to print: AASI – Testicular 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.