Bleomycin and flying

[beacon_outbound]

Hi everyone, and greetings from the UK! Discovered these forums recently and I must say it’s been very helpful reading through people’s experiences etc.

Around ten days ago I underwent a radical orchidectomy after discovering a lump the week previous. The histology results came back on Friday confirming the tumour as 100% Embryonal Carcinoma with extensive vascular invasion, stage pT2.

CT scan showed up a 2mm LUL pulmonary nodule, “indeterminate”, with the report recommending a follow-up CT scan in 3 months for this.

Met up with the oncologist yesterday and we pretty much decided on getting one cycle of BEP. The oncologist however was thankfully on the ball and pointed out that as I am an airline pilot that the Bleomycin may have an effect on my lung capacity. I have contacted the Civil Aviation Authority who have responded stating that if the Bleomycin does end up affecting my lung capacity I *could* be permanently grounded from flying.

The alternative to BEP would be two cycles of EP instead.

I know there are many threads on here relating to scuba diving and Bleomycin however, just wondering if there's anyone on here who is / knows a pilot who has undergone BEP and how this affected them? I'm especially concerned that should I need to put on an Oxygen mask during an emergency whilst flying (such as a rapid depressurisation or a fire/smoke/fumes event) - would this then cause issues after being exposed to Bleomycin..?

Also, can the chances of lung issues resulting from Bleomycin be quantified at all, in say a percentage?

Final question, I promise! If I chose to have two cycles of EP instead, is this less effective in long term prognosis of the cancer reoccurring when compared to having the one cycle of BEP?

Sorry for such a long post!


Cheers

[biwi]

I don't know if anyone on here can give you information with enough authority to rely your livelihood on it.

That being said, I think the cumulative effect is just as important, and only one Bleo is much less drugs than 3 Bleo.

I would pose this question to some of the TC experts and get their opinion on it. There are probably studies that quantify the effects of Bleomycin as well, and they probably could refer you to them.

[Davepet]

Well, I am no doc, but it sure seems to me that bleo caused lung problem concerns are way overblown & actually quite rare. However if it happens to you, the fact that it is rare is not important.

I actually would question the need for further treatment *and* if further treatment is advised if one course would be advisable. I suggest you contact Doc E for his thoughts on this. Your profession complicates this a bit after all.

Dave

[beacon_outbound]

Thanks for your replies. You’re right - it really is a tough decision to make, and my line of work is definitely a complicator.

I was told that if I go down the surveillance route then the chance of relapse would be 40-50% within 12-18 months.

I’ll let you know what I decide on.

Cheers

[Balance]

Take a look at the last post on this thread. He is a pilot like me and he did BEP with no issues and is back flying. I am a pilot, but I had an RPLND. I may have to do chemo later on, but I’ll cross that bridge if I get there. I am also going to do some research. Hope that helps

http://www.tc-cancer.com/forum/forum/during-treatment-and-beyond/treatment-after-the-orchiectomy-radiation-chemotherapy-rplnd-surveillance/314849-just-joined-the-club/page2

[beacon_outbound]

That’s actually very helpful, thank you.

Dr. Einhorn very kindly replied to my email. He said there is “zero concern” with Bleomycin in both pilots and scuba divers. Reassuring but I’m a bit confused after reading about how Bleomycin can react badly with pure oxygen.

He also said that in his opinion that 2 x EP is equally effective as 1 x BEP.

Hope everything goes well with you, Balance.

[Davepet]

Doc E *discovered* BEP for TC. Nobody knows more than he does about it. Anything else you read is a distant second place opinion as far as I'm concerned.