As a retired registered nurse, Gail DiPaolo of Manchester understands the importance of preventive care. So when her local newspaper advertised AngioScreen, she thought it was a good idea to have the inexpensive, non-invasive evaluation to learn her risk of cardiovascular disease. After the 15-minute scan, a nurse explained her results. While her heart and blood vessels were fine, Gail was surprised to learn there was a suspicious nodule on her thyroid gland. That was identified during the portion of the screening where a portable ultrasound machine is used to look at the neck area.

She saw her family doctor, who ordered a CT scan that confirmed she had nodules on both sides of her thyroid. A biopsy was inconclusive. While Gail was going through testing, she researched the best specialists in her area so she would be prepared for whatever came next. She consulted with a surgeon and with endocrinologist Niyati Umesh Chiniwala, M.D. at Jersey Shore University Medical Center, who suggested repeating the ultrasound on her neck in six months to see if the nodules grew.

Repeat Testing for Thyroid Nodule Growth

After the repeat ultrasound six months later showed little change, Gail had another visit with Dr. Chiniwala, who offered her the choice to continue repeating scans and biopsies until a definitive diagnosis could be made or to remove her thyroid instead.

Dr. Chiniwala explained that Gail’s initial biopsy was classified as atypia of undetermined significance, which has a 10–15% chance of being malignant. She ordered a genetic test on the biopsied tissue that dropped Gail’s odds of cancer down to about 5%.

“However, Gail’s tumor was large at 3 cm—and the larger a nodule is, the more likely a false positive biopsy is, since it might include tissue from a part of the nodule that doesn’t contain abnormal cells, while another part might,” says Dr. Chiniwala.

Gail didn’t want to take any chances. Knowing the only way to know for sure if she had cancer was to remove her thyroid, Gail had an outpatient thyroidectomy at Jersey Shore University Medical Center.

“After the surgery, I got a more definitive diagnosis of cancer,” Gail says. “I was shocked but very lucky because it was encapsulated and hadn’t spread to my lymph nodes. If I hadn’t had the AngioScreen, I would not have caught it so early.”

Treatment Options for Thyroid Cancer

Following a quick recovery that left no visible scar, the next choice for Gail to make was whether or not to undergo radioactive iodine therapy, a traditional element of treatment for thyroid cancer.

“We discussed radioiodine therapy because she had a multifocal follicular tumor,” says Dr. Chiniwala. Although radioiodine therapy can be lifesaving for people with aggressive tumors, it can make the patient radioactive for a few days after treatment, and it has recently fallen out of favor for low-risk tumors. Dr. Chiniwala suggested a second opinion with an endocrinologist specializing in thyroid cancer. Gail and her medical team decided to forgo radioiodine and instead keep a close eye on Gail.

Gail continued to see Dr. Chiniwala twice a year for bloodwork and ultrasounds. It’s now been over five years since the cancer was removed, meaning she’s at a low risk for recurrence. Gail will continue to take Synthroid, a synthetic thyroid hormone, for the rest of her life. Dr. Chiniwala monitors Gail’s thyroid stimulating hormone (TSH) and fine tunes her dosage as needed to respond to natural fluctuations.

“I was very grateful it happened the way it did and to have two great endocrinologists following me,” Gail says. “The AngioScreen is such an inexpensive and quick test. It’s simple and a great way to catch things early, even if it’s not what you were expecting.”

Next Steps & Resources

• Meet our source: Niyati Umesh Chiniwala, M.D.
• Schedule an AngioScreen
• To make an appointment with an endocrinologist near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.