A routine physical uncovers an unexpected cancer diagnosis

Just two months after graduating from high school, Ava Carosielli was diagnosed with papillary thyroid cancer.

Chris Carosielli would be the first to tell you that having her 19-year-old daughter, Ava, diagnosed with cancer just a few months after high school graduation wasn’t on her bingo card for 2026.

Ava was preparing to begin college at Henderson State University in Arkansas. The four-year state qualifier for North Canton Hoover High School had been recruited to swim. She had also chosen aviation as her major, reflecting a lifelong passion.

As part of the process to become a student pilot, Ava needed a physical exam through the Federal Aviation Administration.

Ava (left) was a four-year state qualifying swimmer for Hoover and had been recruited to swim at Henderson State University in Arkansas.

A routine exam reveals something unexpected

During the exam, the physician noticed that Ava’s thyroid was enlarged. The doctor encouraged her to have it checked by her primary care provider.

On July 6, Ava saw her provider. The doctor suspected a swollen lymph node related to an illness Ava had recently been fighting.

Ava was diagnosed with thyroiditis, an inflammation of the thyroid. Her doctor recommended an ultrasound to make sure there wasn’t something else going on.

“The ultrasound showed a 2.4-centimeter nodule on the right side of Ava’s thyroid gland,” Chris said. “They still suspected a massive infection but ordered follow-up testing.”

For Ava, the diagnosis came at a particularly difficult time. She was preparing to start college and begin the next chapter of her life.

But scheduling that testing proved difficult.

“No one in Canton, where we live, could get us in until the end of August. That was when Ava was due to leave for college,” Chris said.

Chris wasn’t willing to wait. She reached out to a friend who had connections at Akron Children’s. That decision led to a much quicker diagnosis.

On July 23, Ava saw Akron Children’s endocrinologist Dr. Mamatha Kambalapalli. She quickly diagnosed Ava with papillary thyroid cancer.

“Honestly, I was shocked,” Ava said. “I was 19 and getting ready to leave for college, so cancer was the last thing I ever expected to hear. At first, I think I was more scared about how much my life was about to change than anything.”

Ava had surgery to remove her thyroid within 10 days of her initial visit.

A cancer diagnosis changes the plan

At that first visit, Dr. Kambalapalli ordered another ultrasound with lymph-node mapping. The scan showed that the cancer had spread to some of Ava’s lymph nodes and beyond.

“This scan helps us identify any abnormal lymph nodes that should be biopsied along with the thyroid nodule,” said Dr. Kambalapalli. “This information is useful for surgery planning.”

Four days later, Ava had a biopsy of the lymph node and thyroid nodule. She was scheduled for surgery on Aug. 3 with pediatric general surgeon Dr. Anghela Paredes to remove her thyroid.

Dr. Kambalapalli said Ava was one of the quickest of her patients to get surgery. She had the procedure within 10 days of her initial visit.

“This took a whole team effort from radiology, interventional radiology, pathology and surgery, as well as the family being flexible,” she said.

“Knowing the timeline for Ava’s college start, we had to expedite things from our end,” added Dr. Kambalapalli. “When I told my team about the need to get Ava to college on time, everyone was willing to make accommodations in their schedules to fit her in.”

Following surgery, Ava began radioactive iodine treatment for her cancer.

A quick path to treatment

Chris was still shocked by her otherwise healthy daughter’s cancer diagnosis. But Dr. Kambalapalli reassured her that papillary thyroid cancer is one of the most common and treatable forms of cancer.

For Ava, the diagnosis came at a particularly difficult time. She was preparing to start college and begin the next chapter of her life.

“It was really hard because I had worked for so long to get to that point,” Ava said. “I was so excited to swim in college and start aviation, and then all of a sudden everything I had planned felt like it was being taken away from me.”

The morning of her surgery, Ava and her mom were in the gym at 5:30 a.m. working out. Three days later, Ava was back at work as a lifeguard.

“Ava is the toughest girl I know,” said Chris.

Ava in her dorm room at college.

Treatment continues after surgery

Surgery was only part of Ava’s treatment.

The next phase brought another major adjustment: a low-iodine diet.

“This included no dairy, eggs or seafood,” Chris said. “Since the thyroid needs iodine, the idea was to starve any remaining cancer cells.”

Ava also took a radioactive iodine pill. She then had to isolate for four days while the treatment did its job.

“Management of papillary thyroid cancer often involves surgery alone in low-risk cases,” said Dr. Kambalapalli. “Since Ava’s had spread to her lymph nodes, radioactive iodine therapy was also needed.”

Ava keeps college in sight

Through it all, Ava kept her sights on college.

“I just didn’t want cancer to take any more from me than it already had,” Ava said. “Getting back to school gave me something to work toward and made me feel like I was getting a little bit of my normal life back.”

Ava remained at home for one to two weeks to complete her radioactive iodine treatment. She still hoped to make it back to Henderson State University for orientation and the first day of classes.

“I also have a daughter in college, and I know how important it is for them to be part of the orientation and first day in college,” said Dr. Kambalapalli. “I was very happy that Ava didn’t miss that experience.”

Ava said getting back to school gave her something to work toward and made her feel like she was getting a little bit of normalcy back.

Back to the life she planned

Chris said Ava is continuing to live her life.

“She hasn’t really missed a beat,” she said. “She kept up with classes online while at home and returned to school on Sept. 5.”

Chris also believes Ava’s experience as an athlete helped her handle the challenges of cancer.

“I think her career as an athlete has helped her deal with this mentally and emotionally,” Chris added. “She’s got grit.”

Ava agrees that swimming helped prepare her for the experience.

“Swimming has taught me how to push through things when they’re hard and how to keep going even when I don’t want to,” she said. “There were definitely days during all of this where I had to use that same mindset and just focus on getting through one thing at a time.”

Now back on campus, Ava is focused on the things she had been looking forward to all along: swimming, studying aviation and spending time with her teammates and friends.

“I’m honestly just excited to be doing normal college things again,” Ava said. “I’m really looking forward to getting stronger in the pool, continuing aviation, being with my teammates and friends, and getting to enjoy everything I worked so hard to get back to.”

The experience has also changed how Ava looks at everyday life.

“I don’t take being able to swim, go to school or even just have a normal day for granted anymore,” she said. “I’m just really grateful for everyone who helped me get back here, especially my family and everyone at Akron Children’s who took care of me.”