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FAA CACI Prostate Cancer Worksheet

Pilots with a history of prostate cancer can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist. The AME reviews the treating urologist's or oncologist's progress note, from a visit within 90 days of the exam, and confirms the cancer is stable with no spread or recurrence, active treatment is finished, and a PSA from the last 6 months is under the FAA limit.

Who completes it

The AME completes the checklist and marks the Block 60 outcome. The treating urologist, oncologist or other specialist writes the current, detailed Clinical Progress Note and reports the recent PSA.

Submitting and payment

How to submit it
A qualifying case is noted as 'CACI qualified prostate cancer' in Block 60 of FAA Form 8500-8, and the documents do not need to be submitted. Otherwise the AME defers and submits the supporting documents.

Good to know

  • PSA within the last 6 months must be 20 or less without prostatectomy, or 0.2 or less after prostatectomy.
  • Accepted current treatment is none, active surveillance or watchful waiting, or brachytherapy. Chemotherapy or radiation must be completed with no further treatment recommended.
  • After surgery, the note must confirm the pilot is off pain medication, fully recovered and released by the surgeon. There can be no current or past metastatic disease.
  • If 5 or more years have passed since any treatment, with no metastasis or recurrence, the CACI is not required; the AME notes this in Block 60.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Prostate Cancer Worksheet

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

What PSA level does the FAA accept for the prostate cancer CACI?

A PSA drawn within the last 6 months must be 20 or less if the pilot has not had a prostatectomy, or 0.2 or less after prostatectomy. The treating physician's note should report the value and date so the AME can confirm it before issuing.

Does the prostate cancer CACI allow active surveillance?

Yes. The worksheet accepts active surveillance or watchful waiting as current treatment, as well as brachytherapy or no treatment, provided the cancer is stable without spread or recurrence, has never metastasized, the PSA meets the limit and the pilot has no symptoms.