Dynamic risk assessment ?

Hi

I must be honest and say that I’ve never heard of a Dynamic Risk Assessment. 
I’ve had a neck ultrasound and thyrogen injections before a full body pet scan.

I hope somebody on here can help you and put your mind at rest. It really is the worse feeling, worrying about tests and results, sometimes it feels never ending.  I really understand how you feel.

Take care xx

Hi,

I had total thyroidectomy in June 2022 followed by RAI in October. Have been on 100mg Levothyroxine daily. Taking blood tests and seeing my oncologist every three months.

The clinic letter I received based on my latest check-up in February says “Blood tests look absolutely fine and thyroglobulin antibodies are negative. I will review her again in three months’ time with repeat bloods but I do not want to reduce the thyroxine dose as yet. If all well at this time, we can move to dynamic risk stratification.”

I think dynamic risk assessment is the same as dynamic risk stratification. They want to give us all these tests to assess the risk of recurrence of cancer, based on which they decide future treatment strategy. So all these different tests sound daunting, it is a positive process we all need to undergo to move forward. 

This is my understanding, hope this has helped?

Hi Peartree 

I think this is exactly what my hospital calls a dynamic risk assessment so I’m sure it’s the same thing you have gone through (injections and pet scan)

Thank you for your reply and for being so kind xx

Hi Lotus Flower 

thanks so much for your reply - I think you’re right - I googled dynamic risk stratification and it seems to be the same thing. 
thanks for sharing I’m glad your results have been ok keeping my fingers crossed everything remains so xx

Umm I think I’m having the same thing in April too, though I had no idea it was called this! I was told blood tests, thyrogen, and some scans to determine how successful treatment has been and then they’ll decide what to do next. I’m determined not to worry about it - there’s nothing I can do!

In the old days, we just used to call this 'follow up scans' but there's nothing like a fancy term to make things seem more scary.

My oncologist once explained that the tests they do 6 months or so after RAI are the best for telling them whether everything worked or not. It also allows them to formally do the TMN 'stage' for the cancer. The important thing to remember is that you'll get pretty much the same treatment regardless of the precise staging so try not to get too hung up about it.

When surgery is done, they can't do TMN staging because they don't know if there is any metastasis outside the neck area.

When they do your post RAI scan, it's way too indistinct for them to spot anything outside the neck with the necessary detail

But when it comes to the small dose scan that follows months later, the RAI has already gobbled up most of the tissue in the neck area and anything that lights up elsewhere will be more precise. 

For those who have had surgery and RAI that has completely cleared everything up, this process is the point in time when you can say "Yep, we've cracked it. All looks great"

For those who still have something to tackle, it's a case of "At least we now KNOW what we have to deal with, so let's get on an tackle it"

Either way, this is a really important part of your TC experience.

That is my understand of it too @Lotus Flower @Peartree, still waiting for my follow up with my Oncologist after RAI treatment just before Christmas so will probably find out more then.

That would explain when I asked my surgeon recently what stage I was that he said they didn't like to use stage as it was more complicated than putting a number on it @barbaral.  I know the details where I was pre surgery so assessed the TNM staging for myself based on my own research, but as I am still waiting for my follow up post RAI I guess they will tell me more then, and later in 6 months or so after another scan etc., but he wouldn't say whether I was Stage IV or not, which I think I am based on my age, spread, size of original tumour.

Hi Pinkbluepurple 

Now I’m aware that a dynamic risk assessment is the new term for follow up I can tell you my experience!

I had bloods done on the Monday to check my thyroglobulin levels. Tuesday and Wednesday I had the thyrogen injections. Thursday I had the scan. Not the biggest fan of the scan but it has to be done and really it’s not to bad atall. Think the worse part of it all was the low iodine diet I had to follow two weeks prior to the scan! 
Im sure I waited just a couple of weeks for the results. Horrible time but you just have to try and keep positive and definitely keep busy. 
I just have neck ultrasound and CT scan every 6 months at the moment. 

Sending positive vibes  ….. xx