Prostate Biopsy
 

Does anyone know if you are deemed unfit whilst waiting for a prostate biopsy in UK?
Sent for MRI after one PSA test (11.5), nodule confirmed, awaiting guided biopsy in 5 weeks

Thanks

You can fly until you are officially diagnosed with Cancer. I had a PSA of 7 rising to 12 over eighteen months. I then had an MRI and a transperrenial biopsy after which I was told I had a Gleason score of 7 (4+3) which was industrial grade PCa. The choice is given to you over what treatment you'd prefer being surgery or Hormone/Radio however look out for a heavy bias towards people recommending surgery. I chose the alternative and had to suspend flying for treatment plus one month post hormone and then again treatment plus one month post radio therapy. In all I was off for around four months with a short revalidation in the middle. I'm pleased to say after a year that my PSA has remained well below 0.5 so hopefully I have nailed it for now.

Hormone's not too bad. You lose the ability to indulge in sex, but the nice part is you also lose interest in pursuing it. I was more interested in knowing what time the Formula one was on and without the testosterone (which the cancer feeds on) I became a calmer and more placid person. So much so my wife wants me on it permanently ;-)

I was lucky to be treated with the latest image guided intensity modulated accelerators at Christies in Manchester so the radio was a doddle. You simply lie on a table for twenty weekdays and watch a machine rotate around you. No pain, no sensation. Pull your trousers up and drive home. At the end I did have inflammation in the rectum that caused a few issues for about ten days but a good laxative helped that along. Post treatment I'm still as fat and ugly as before but can't thank the team at Christies enough.

I see you're located in London. Should you need treatment ask for the same kind of accelerator, the side effects are much less and collateral damage to the rectum is minimised. You are also located near some hospitals offering Cyberknife treatment which is much more precise and can offer treatment in five days.

One thing I would recommend is getting your AME onside as soon as possible. Strictly speaking the biopsy is an intrusive procedure so should be notified. The CAA guidelines say grounding is only required 'on confirmation' of cancer, and you haven't got it yet.

This is your guiding reference:

CAA Protocols. Oncology.

Good Luck.

Be very very careful. An abnormally high PSA or a lesion on an MRI is an abnormality and must be reported. A 'working diagnosis' of cancer is cancer for the purposes of the medical. Many patients have repeated negative biopsies, especially if not MRI guided grid biopsies, before a positive histology report. I would strongly advise reporting the abnormalities as they occur to avoid the risk of flying without a license and flying uninsured.....

I kept my AME briefed throughout the whole process and he monitored everything up to the positive diagnosis. It was only then that the CAA protocol kicked in and said I couldn't fly. I got re-certified after one month on HT to check for side effects, and then another month after completion of RT for the same reason. I would stress that this was for an EASA Class 2 and not Class 1 which is dealt with by the CAA and not the AME. Again, refer to my link to the CAA protocol above for guidance.

Leading up to diagnosis you are no different in fitness from one day to the next. I agree however that ones mental state may be preoccupied but there are many other stresses in life that can re-create that. Marriage for a start...... ;-)

My MD gives me a blood work and urinalysis sheet every year. I told him to leave off the PSA test as at my age it just becomes more common without serious consequence. Diagnostic procedures and treatment are in many cases worse than the pathology.

The High Prevalence of Undiagnosed Prostate Cancer at Autopsy: Implications for Epidemiology and Treatment of Prostate Cancer in the Prostate-Specific Antigen-Era

Of course YMMV. Family history is relevant.

Prostate cancer metastasis typically occurs in the bones, lymph nodes, lungs, liver and brain. It is that last possibility that gingers up the UK CAA somewhat. I think it is true to say that the authority is pretty relaxed about prostate cancer that has not yet escaped from the prostatic capsule. Actually and come to think of it, the UK CAA is pretty decent altogether when it comes to cancer and having bits chopped out of one whilst maintaining, with occasional periods of set aside, a Class I medical.