Hello, everyone. I'm in Los Angeles, female, 6os, being treated at UCLA. Diagnosed in Fall 2021 with aggressive PDTC with TERT+ and NRAS mutations. Surgery in October 2021 to remove 8cm mass resting against windpipe and a complete thyroidectomy, followed by RAI treatment. Surveillance through PET CT and neck U/S every 3-6 months. TG levels remained below 3 for the better part of 18 months and then began to rise, pretty much doubling every 3 months. A second course of RAI was given in December 2023-- had zero effect apart from the unfortunate side effects (extremly dry mouth, dry eyes-- both being handled/treated). In January 2025, neck U/S revealead two small masses in neck area and a suspicious lymph node. Another whole-body PET CT revealed no metastasis and a neck U/S/ and surgery scheduled for March 2025. In the two months between first and second neck U/S, two more small masses discovered by surgeon. Surgery completed and another round of genetic testing (more sophisticated than in Summer 2021) revealed no changes in mutuations, no futher mutuations implicating possible treatment-- and no effective targeted treatment or immunotherapy available at this time. Had another PET CT early this month that, thankfully, did not yet reveal metastatis. However, TG levels dropped immediately following the recent surgery and then rose 20 points in six weeks (not at 91), leading at least one of the doctors to opine that there is microscopic disease lurking somewhere that has not yet revealed itself. The recommendation was to do a course of adjuvant radiation therapy to try to stave off future recurrences in the neck, at least, while I still can do so-- another PET CT in six months might reveal disease elsewhere and then radiation is off the table without any known to be effective systemic treatment available. About to undergo TrueBeam VMAT IMRT, 33 treatments to the positive margins, operative bed, and bilateral nodal through IV. The doctors and PA's have prepared me pretty well for this-- and I am not undergoing chemo or any systemic treatment, just radiation to the neck. Appreciate hearing about the worst side effect anyone has suffered from similar adjuvant course of IMRT w/o chemo, etc. Thank you, and wishing you all the smoothest possible navigation through your own journeys.