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Rare Hereditary Tumor Gene

Squeeps

New Member
First time poster here needing some Doc advice. So I'm in an interesting situation. I'm in the process of finalizing my application for SNA with the Navy, but I just hit a bit of a bump. After a distant cousin of mine (in his mid-30s) had a couple benign tumors removed, my family got ourselves tested for this gene that causes hereditary paraganglioma-pheochromocytoma syndrome. It's basically a gene that gives you a predisposition, but not a guarantee, to developing these tumors that are almost always benign in nature.

Now, I've already been through NAMI in Pensacola, and everything checked out, but this has come up since then on the side. I told my recruiter about the situation, and he told me basically to withhold from telling medical until after I go through OCS, if I'm to get in. Which doesn't sound right at all.

Here a link to a description of the condition (forgive me if I'm breaking some forum rule for external links):
https://www.stjude.org/disease/hereditary-paraganglioma-pheochromocytoma.html

The worrisome thing about these is that hypoxia has been shown to have a correlation with them developing, although I feel that hypoxia is typically avoided with modern pressurization and oxygen in cockpits, except it may be encountered in training for a short time.

This would be one of those "don't volunteer information" things, but the thing is, it's recommended I get an MRI every two years just to check if anything's developed. I've already just had one, and everything checked out just fine. I just don't want to start off lying to the Navy, especially since this would probably have to come out eventually.

Basically, I'm wondering (1) what I should do regarding disclosing this and (2) how this could affect my application.

Thank you.
 

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
When filling out your flight physical paperwork, would you check "YES" in any of the boxes? If you're checking "YES," then disclose something, but if you're checking "NO" and answering the question honestly, then you're not hiding something. The maternal side of my family has a history of cancer, but I don't check "YES" in the box saying I have had any kind of cancer.

Don't over-think this. Your honesty is applauded, but try and find things that might happen in the future when you fill out your flight physical forms. As for hypoxia, if you go helos, you'll probably experience some sort of very mild hypoxia (I forget what it comes out to, but something like 98% O2 sat. for a healthy, non-smoking adult) when you're at altitude. Otherwise, you'll only really experience any kind of planned hypoxia during your initial training at API and then every 4 years after that.
 

Squeeps

New Member
When filling out your flight physical paperwork, would you check "YES" in any of the boxes? If you're checking "YES," then disclose something, but if you're checking "NO" and answering the question honestly, then you're not hiding something. The maternal side of my family has a history of cancer, but I don't check "YES" in the box saying I have had any kind of cancer.

Don't over-think this. Your honesty is applauded, but try and find things that might happen in the future when you fill out your flight physical forms. As for hypoxia, if you go helos, you'll probably experience some sort of very mild hypoxia (I forget what it comes out to, but something like 98% O2 sat. for a healthy, non-smoking adult) when you're at altitude. Otherwise, you'll only really experience any kind of planned hypoxia during your initial training at API and then every 4 years after that.

I guess you're right. Thinking back, I don't think there was any place on the medical form that asked for any other conditions other than the specific check boxes. I'm just trying to pick some minds about it before I say something and get wrapped up in a potential mess of paperwork. Thanks.
 

TimeBomb

Noise, vibration and harshness
(adsbygoogle = window.adsbygoogle || []).push({}); You haven't been diagnosed with anything; you've been identified as being at a higher risk. Since you haven't been diagnosed with anything there's nothing to report.
Concur. Excluding applicants for latent findings that may cause subsequent medical problems is a very slippery slope. I doubt there's a one of us who doesn't have some genetic skeletons in the closet that could predispose us to something nasty down the road. The only problem I can foresee is meeting the surveillance requirements described in the original post. However, with some attention to detail, it probably won't be a major problem. As an aside, just because a neoplasm (like pheochromocytoma) isn't cancerous, doesn't mean it's trivial and without health consequences. Pheochromocytoma is a bad actor, and if untreated can lead to real problems.
R/
 

Squeeps

New Member
Concur. Excluding applicants for latent findings that may cause subsequent medical problems is a very slippery slope. I doubt there's a one of us who doesn't have some genetic skeletons in the closet that could predispose us to something nasty down the road. The only problem I can foresee is meeting the surveillance requirements described in the original post. However, with some attention to detail, it probably won't be a major problem. As an aside, just because a neoplasm (like pheochromocytoma) isn't cancerous, doesn't mean it's trivial and without health consequences. Pheochromocytoma is a bad actor, and if untreated can lead to real problems.
R/


That's my main concern as well. So would you suggest I withhold volunteering the info for now and bringing it up eventually? I just don't know how to bring that up without it causing some major concern or vice versa where they wouldn't see enough reason to check. "Oh yeah doc by the way, you might wanna give me an MRI about now..."
 

Pags

N/A
pilot
That's my main concern as well. So would you suggest I withhold volunteering the info for now and bringing it up eventually? I just don't know how to bring that up without it causing some major concern or vice versa where they wouldn't see enough reason to check. "Oh yeah doc by the way, you might wanna give me an MRI about now..."
Your application paperwork isn't going to result in you getting any sort of treatment just unnecessary scrutiny. The NAMI process isn't there to ID issues and fix them but instead to ID issues and get rid of applicants who require fixing. Since you DO NOT have a condition yet answer the questionnaire truthfully with regards to your present state. Once you get accepted and are in the truncate system then it's something you'll want to bring up with your doc and develop a screening methodology. In the meantime if you're really concerned about this and the application process exceeds two years then get an MRI through your civilian doc. How much you want to go looking for problems on a routine basis prior to acceptance is up to you. But if between now and being accepted you find something then you'll have to talk to the doc about it once on the next time you fill in the form.
 

Squeeps

New Member
Thank you for the advice. As mentioned before, I probably am putting way too much thought into this, but I just wanted to run it by someone with a lot more experience in this realm so I don't get unexpectedly tripped up somewhere.

Thanks for all the replies. I'll carry on and update this thread if I can remember to down the road.
 

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
That's my main concern as well. So would you suggest I withhold volunteering the info for now and bringing it up eventually? I just don't know how to bring that up without it causing some major concern or vice versa where they wouldn't see enough reason to check. "Oh yeah doc by the way, you might wanna give me an MRI about now..."

It's a very easy process. Once you're at Primary (or whenever you hit the point needing the MRI, as long as it's AFTER starting API), you go to the doc and say what you've said here. "Hey doc, my family got tested for weirdo genetic disposition. I've been doing some research and it looks like we need to discuss a monitoring plan..." Given the experience of some of the flight docs you'll run into, you'll probably know more initially than they will, but regardless, they'll refer you to the nearest hospital to hang out with all of the retirees and to see a specialist.
 

Flash

SEVAL/ECMO
None
Super Moderator
Contributor
It's a very easy process. Once you're at Primary (or whenever you hit the point needing the MRI, as long as it's AFTER starting API), you go to the doc and say what you've said here. "Hey doc, my family got tested for weirdo genetic disposition. I've been doing some research and it looks like we need to discuss a monitoring plan..." Given the experience of some of the flight docs you'll run into, you'll probably know more initially than they will, but regardless, they'll refer you to the nearest hospital to hang out with all of the retirees and to see a specialist.

To be frank I would think about waiting until after getting winged. I had something pop up with my eyes right after I got winged and one of the NAMI docs said it was much easier to deal with since I was winged and there are different standards (more relaxed in my case) that apply to winged folks.
 
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zippy

Freedom!
pilot
Contributor
You haven't been diagnosed with anything; you've been identified as being at a higher risk. Since you haven't been diagnosed with anything there's nothing to report.

This...

That's my main concern as well. So would you suggest I withhold volunteering the info for now and bringing it up eventually? I just don't know how to bring that up without it causing some major concern or vice versa where they wouldn't see enough reason to check. "Oh yeah doc by the way, you might wanna give me an MRI about now..."

I would not bring this up until you're in a fleet squadron.... FRS at the absolute earliest... worse case just go get an MRI on your own and pay out of pocket to give yourself a warm and fuzzy, unless of course you see something developed out of the ordinary. No body will care about you or your professional future as much as you do while you're in student status. Once you hit the fleet squadron, the command has a vested interest in keeping you med up and healthy and your Doc will be more ammemable to working with you instead of seeing it as their duty to screen people and find those unfit to fly.
 

Squeeps

New Member
Great advice, thanks guys. It looks like at least waiting until after winging to bring it up is the best choice. Hopefully by then they'd have enough invested in someone like me to set up some sort of plan for it, if it's seen as needed.
 
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