Medically reviewed by Dr. Alan M. Tebby, D.C., FMCSA Certified Medical Examiner | Last updated: January 27, 2026
TL;DR: DOT Physical Cancer History
Cancer history doesn’t automatically disqualify you from DOT certification. Many cancer survivors drive commercially after treatment. The key factors are: current disease status (stable/remission), ability to perform driving functions, and whether any ongoing treatments or medications affect driving safety. Most certification decisions are based on oncologist documentation of your current status and prognosis.
At Charlotte DOT Exam Center, our FMCSA-certified examiners have extensive experience evaluating this condition.
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📑 In This Guide
Understanding Cancer History and DOT Physical Certification
A cancer diagnosis changes your life, but it doesn’t necessarily end your commercial driving career. Thousands of cancer survivors maintain DOT certification after treatment. The FMCSA evaluates cancer based on current functional status and driving safety rather than diagnosis history alone.
The evaluation focuses on several factors: Is your cancer in remission or stable? Do you have any functional limitations from the cancer or its treatment? Are your current medications compatible with commercial driving? Can you perform required driving functions safely?
At Charlotte DOT Exam Center, we work with many cancer survivors pursuing or maintaining certification. Our examiners understand how to evaluate cancer history and can help you understand what documentation supports your certification.
What Is Cancer History?
Cancer history includes any past or current malignancy. For DOT purposes, the concern is whether the cancer or its treatment affects your ability to safely operate a commercial vehicle. This depends on cancer type, treatment, current status, and any lasting effects.
How Common Is Cancer History?
Over 18 million Americans are cancer survivors. Many maintain active careers including commercial driving. Advances in cancer treatment have significantly improved survival rates and quality of life, allowing more cancer survivors to continue working.
FMCSA Standards for Cancer History
The FMCSA physical qualification standards are found in American Cancer Society. According to the FMCSA Physical Qualifications, cancer history affects many Americans, including commercial drivers.
The FMCSA evaluates cancer history based on functional capacity—your ability to safely operate a commercial motor vehicle. Key factors the medical examiner considers include:
- Current condition status: Is your condition stable and well-managed?
- Functional ability: Can you perform all required commercial driving tasks?
- Medication effects: Do your medications impair driving ability?
- Safety risk: Could your condition cause sudden incapacitation?
- Documentation: Do you have adequate records supporting certification?
For additional information, see the NCI Cancer Survivorship and American Society of Clinical Oncology.
Common Questions About Cancer History and CDL Certification
Commercial drivers with cancer history often have similar questions. Here are the most common questions we answer at Charlotte DOT Exam Center:
Can I get a CDL if I have a cancer history?
Yes, many cancer survivors obtain and maintain CDL certification. Certification depends on your current disease status, functional abilities, and whether treatments affect driving safety. Cancer in remission with good function is typically certifiable.
Do I need oncologist clearance for DOT certification?
For recent cancer, active treatment, or significant history, oncologist documentation is typically required. A letter stating your current status, treatment plan, functional abilities, and opinion on fitness for commercial driving is helpful.
How does active cancer treatment affect certification?
Active treatment (chemotherapy, radiation) may temporarily prevent certification due to side effects like fatigue, nausea, or cognitive effects. Certification is usually possible after treatment completion and recovery.
What about cancer medications and commercial driving?
Most cancer treatment medications are used during active treatment periods when driving certification is typically deferred. Maintenance medications (hormone therapy, targeted therapy) are often compatible with driving once stable.
How long after treatment can I be certified?
This varies by cancer type and treatment. Generally, a period of stability after treatment completion (often 3-6 months minimum) is expected. Your oncologist can advise on appropriate timing.
Does cancer history affect certification duration?
Recent cancer history or ongoing monitoring may result in shorter certification periods (1 year) to allow more frequent evaluation. Long-term survivors in stable remission may receive standard 2-year certification.
What if my cancer returns?
Cancer recurrence requires re-evaluation. Active cancer treatment typically prevents certification temporarily. Your certification status after recurrence depends on treatment, response, and functional recovery.
What about brain tumors?
Brain tumors require careful evaluation due to potential effects on cognition, vision, seizure risk, and motor function. Neurologist and oncologist clearance is typically required, and certification depends on tumor type, treatment, and lasting effects.
Cancer History and Commercial Driving Medications
Understanding which medications are compatible with commercial driving helps you prepare for your DOT physical and communicate effectively with your medical examiner.
💊 Medication Compatibility Chart
| Medication Category | Common Examples | CDL Compatible? |
|---|---|---|
| Hormone Therapy | Tamoxifen, letrozole, anastrozole | ✅ Yes (after stabilization) |
| Targeted Therapy | Imatinib, other kinase inhibitors (maintenance) | ⚠️ Evaluate for side effects |
| Immunotherapy | Checkpoint inhibitors (maintenance) | ⚠️ Evaluate for side effects |
| Pain Medications | For cancer-related pain | See chronic pain guidelines |
| Anti-nausea Medications | Ondansetron, etc. | ✅ Yes (if needed) |
| Active Chemotherapy | Various regimens | ❌ During active treatment |
✅ = Compatible | ⚠️ = Requires evaluation | ❌ = Not compatible while driving
Certification Duration Based on Cancer History Status
Your DOT medical certificate duration depends on your condition’s status, treatment effectiveness, and documentation provided:
📊 Certification by Severity
| Severity Level | Characteristics | Typical Certificate | Documentation Required |
|---|---|---|---|
| In remission (5+ years) | No evidence of disease, completed treatment | 2 years | Oncologist confirmation |
| In remission (recent) | No evidence of disease, <5 years from treatment | 1 year | Oncologist documentation |
| Stable disease | Cancer present but controlled | 1 year | Oncologist documentation + monitoring plan |
| Active treatment | Currently receiving chemotherapy/radiation | Defer certification | Re-evaluate after treatment |
| Metastatic (stable) | Advanced cancer but stable/controlled | Case-by-case | Oncologist clearance required |
⏳ Waiting Periods
| Situation | Typical Wait | Documentation Needed |
|---|---|---|
| After chemotherapy completion | 3-6 months minimum | Oncologist clearance + recovery documentation |
| After radiation therapy | 2-3 months minimum | Oncologist clearance + side effect resolution |
| After cancer surgery | 6-12 weeks typically | Surgeon clearance + functional recovery |
| After brain tumor treatment | Seizure-free period + clearance | Neurologist + oncologist clearance |
What to Bring: Documentation Checklist
Proper documentation streamlines your DOT physical and supports certification. Gather these items before your appointment:
Required Documentation
- ✅ Cancer diagnosis and treatment history
- ✅ Current disease status (remission/stable/active)
- ✅ Current medication list
- ✅ Oncologist contact information
Recommended Documentation
- 📋 Oncologist clearance letter with current status
- 📋 Recent imaging or lab results showing stability
- 📋 Treatment completion documentation
- 📋 Functional assessment if limitations present
🚨 After Hospitalization
- 🏥 Hospital discharge summary
- 🏥 Surgical pathology reports if applicable
- 🏥 Oncologist follow-up records
- 🏥 Clearance for return to driving activities
Related Conditions and Resources
Drivers with cancer history may have related conditions also evaluated during the DOT physical:
- DOT Physical Medical Conditions
- post-surgery clearance
- chronic pain management
- autoimmune disorders
- prohibited medications
For complete information, see our DOT Physical Medical Conditions hub page.
Additional Resources
Frequently Asked Questions
Can I get a CDL with cancer history?
Yes, many cancer survivors maintain CDL certification. It depends on current status and functional ability.
Do I need oncologist clearance?
Usually yes, especially for recent cancer or active treatment.
Can I drive during chemotherapy?
Generally no—active treatment side effects typically prevent certification temporarily.
How long after treatment can I be certified?
Varies by cancer type—typically 3-6+ months of stability after treatment.
Does cancer history shorten certification?
Recent history may result in 1-year certificates. Stable long-term survivors may get 2 years.
What about brain tumors?
Requires careful evaluation by neurologist and oncologist due to potential cognitive and motor effects.
Schedule Your DOT Physical at Charlotte DOT Exam Center
Charlotte DOT Exam Center provides expert DOT physical examinations for commercial drivers with cancer history. Our FMCSA-certified medical examiners—Dr. Alan M. Tebby, D.C. and Dr. Lemuel Byrd—have extensive experience with this condition.
📍 Charlotte DOT Exam Center
8415 Pineville-Matthews Road, Suite 102
Charlotte, NC 28226
Monday – Friday: 8:30 AM – 5:00 PM
Saturday: 8:30 AM – 12:00 PM
Sunday: Closed
Questions? Call us at 704-544-3494 to discuss your cancer history and DOT certification requirements.
