Any changes in condition make it impossible for your local AME to renew your medical:




Watch and wait IS the standard of care for certain cases however, which means while it has to go back to OKC they can indeed approve a new SI if the treating physician can make a strong case for that option and come up with a monitoring schedule satisfactory to the FAA. Generally speaking that is more likely to be approved if it comes from a nationally recognized center like MD Anderson, Seattle Cancer Care Alliance, and similar.