Gretchen Hays of Forsyth County began her cancer journey in a most unexpected manner. During a hair appointment in January of 2021, her hairdresser noticed a new spot on the top of Gretchen’s head and encouraged her to get it checked by a doctor.
Gretchen soon visited a dermatologist, Kristin Gregory, PA-C, who examined the lesion and scraped it for a biopsy. That biopsy came back positive for melanoma. Gretchen was referred to Melanoma and Sarcoma Specialists of Georgia, where she saw Dr. Nicole Kounalakis.
Dr. Kounalakis performed a punch biopsy, which confirmed stage 3C melanoma and revealed several precancerous areas around the melanoma. Dr. Kounalakis explained that she would need to remove a sizeable chunk of tissue from Gretchen’s head, so she was also referred to Dr. Farzad Nahai, a plastic surgeon.
Gretchen shared, “I’ve always been a big sunscreen person. As an avid tennis player, I typically wore visors when outdoors. I simply never thought about sun exposure to the top of my head.”
Dr. Kounalakis performed Gretchen’s first surgery to remove the cancer. Then, in a second surgery, Dr. Nahai excised more tissue to obtain a better margin. Additionally, he performed a skin graft by taking skin from Gretchen’s thigh to cover the surgical site on her scalp.
Gretchen’s medical team also performed a biopsy of lymph nodes in her neck, the closest nodes to the melanoma lesion. This biopsy revealed that the cancer had spread to her lymph nodes. A PET scan showed no additional spread beyond those nodes. Because the cancer was also in lymph nodes, additional treatment such as chemotherapy or radiation would be required. Dr. Kounalakis referred Gretchen to Dr. Ioana Bonta, a medical oncologist with Georgia Cancer Specialists.
Dr. Bonta’s first course of treatment for Gretchen was the immunotherapy drug, pembrolizumab. After a few treatments, some dark spots appeared on Gretchen’s scalp around the surgical area. This complication caused Dr. Bonta to quickly pivot in her treatment plan. She discontinued the pembrolizumab and began Gretchen on an oral chemotherapy regimen of encorafenib and binimetinib. This regimen required Gretchen to take approximately 10 pills per day. Gretchen was initially ill from the new treatment, but her body soon adjusted and she continued this treatment for two years.
Gretchen was monitored closely throughout treatment, including checkups with her oncologist, bloodwork and scans every three months; visits to the dermatologist for skin checks every six months; and periodic brain MRIs to monitor for metastasis to the brain.
Because of this thorough monitoring, Dr. Bonta found a spot on Gretchen’s lung in October 2023. The spot was still there on a repeat scan three months later. In January 2024, Gretchen had a lung biopsy that showed metastatic melanoma in her lung.
Dr. Bonta prescribed an aggressive immunotherapy treatment to target the metastatic melanoma. Gretchen shared, “My first treatment went great. After the second treatment, however, I got really sick with severe diarrhea and other gastrointestinal complications. I was terribly dehydrated and weak. As if that wasn’t enough, I fell while running to the bathroom and injured my foot.”
Dr. Bonta advised that Gretchen be admitted to Northside Hospital Forsyth. She was diagnosed with colitis from the immunotherapy drugs, severe dehydration and a broken foot. Gretchen spent six days in the hospital. Dr. Bonta discontinued the immunotherapy treatment and advised Gretchen to simply rest, heal and recover. She continued to visit Northside Forsyth frequently as an outpatient for infusions of saline and potassium to regain her health and strength. She lost nearly 40 pounds from the ordeal. Gretchen reflected, “It was an extremely low point for me. But as my health improved, I was able to join my family for a long-planned vacation in May.”
Dr. Bonta ordered scans in June of 2024 to re-assess the cancer and determine next steps. Gretchen had only received two of the immunotherapy treatments before she became ill and the treatment was stopped. Remarkably, her scans were clear; the cancer in her lung was undetectable.
Gretchen continues to be monitored every three to four months with bloodwork, checkups and scans of her neck, chest and brain.
Gretchen raves about her experience with Northside physicians, staff and facilities.
“Everyone at Northside has been so nice and helpful. They make me feel special. The staff is always there to help me feel better and more comfortable. Additionally, they are very skilled. Their communication is clear and timely, and nothing has slipped through the cracks.”
Gretchen also speaks warmly about her support system throughout treatment. “My tennis team, friends, husband and two daughters carried me through the ups and downs.
My husband accompanied me to every surgery, and friends drove me for infusions and brought meals for my family. I was deeply touched by people’s generosity.”
Today, Gretchen is healthy and active. She exercises regularly, still enjoys lots of tennis and delights in time spent with family and friends. She is a strong advocate for cancer prevention and screening, encouraging her loved ones to get regular skin checks and to protect themselves from the sun with sunscreen, sunglasses and hats. She added, “My tennis teammates all wear hats now!”
“This cancer diagnosis was a blow to all of us! I’ll always remember Dr. Kounalakis’ words of encouragement before my first surgery. She reminded me that I would be the same person after this surgery as I was before, and that cancer is just one part of my journey now. That gave me hope, and now I want to share that hope with others.”
LEARN MORE ABOUT SKIN CANCER CARE AT NORTHSIDE.
*The health story shared here is for informational purposes only and is not medical advice. Patients should consult with their own physician before making medical decisions.
