DES MOINES, Iowa – Diagnosis is the first shock and treatment is the second. Surgery is often the only option for breast cancer patients to finally be cancer-free.

Dr. Scott Hamling is a surgeon with the Iowa Clinic who’s helped cure women of their breast cancer.

“Women are resilient,” Dr. Hamling said. “They’re ready for surgery.”

But each patient’s treatment plan is different, and how doctors figure out who needs what and when has changed throughout the years.

“In the past, most treatments were based largely on patient stage, so size of the tumor or lymph node involvement,” Dr. Hamling explained. “And we always used to say, ‘good news, it’s a small tumor’ or ‘bad news, it’s a big tumor.’ But nowadays, we know it’s the tumor biology. How aggressive do cells grow?”

Because of Calyn’s tumor’s biology, she did need chemotherapy before she had surgery. Dr. Hamling told her that the first time she met him, just days after her diagnosis. But then, she didn’t see him again for months.

“Patients look different when they come in,” Dr. Hamling said, “because I’m seeing them towards the end of last few cycles of chemotherapy when they feel the worst that they probably felt the whole time. Their counts are bad, they feel bad. You know, most have lost most of their hair. Fingernails are not good, and you know, they’re just they’re sick of being sick.”

Even though some patients can’t even feel their lump after chemo, Dr. Hamling says surgery is still necessary.

“We always need surgery to make sure that the cancer is gone,” Dr. Hamling said. 

Calyn’s surgery involved a bilateral mastectomy with reconstruction. A procedure that’s difficult to process before and after it’s complete.

“So physically, you know, a mastectomy changes the body a lot, but emotionally it changes the body a lot,” Dr. Hamling said. “And even if patients don’t feel that early on because you’re focused on oncological care, you know, we have to look at ourselves in the mirror every day. And so our perception, how we feel about ourselves, can change with good or poor outcomes.”

And poor outcomes happen for patients, whether it be complications from surgery or pathology reports that show cancer is still there.

“Giving bad news, there’s no perfect way to do it,” Dr. Hamling said. “And you cannot give bad news the same way with different patients.”

Different patients need different approaches, especially when those patients are young.

“Patients younger than 40 typically have more aggressive tumors and present with more advanced disease,” Dr. Hamling said. “They’re in a certain part of their life where they’re forming their life. You know, relationships, schooling, kids, new jobs, things like that. And you kind of feel like you’re crushing their dreams.”

That’s why Dr. Hamling does what he can to save lives and give people more time, both with surgery and compassion.

“You have to be objective, but have hope,” Dr. Hamling said.

Hope that people can be cured, and his services will no longer be needed.

“That’s probably the most rewarding is that good news,” Dr. Hamling said. “You don’t need me anymore. There’s nothing I can do. You’re perfect. Just go live life. So, it’s a balance but thank goodness there’s more good stories to tell than bad stories.”

Thankfully, Calyn’s story is a good one. Her pathology report came back clear after surgery, however she’ll still meet with Dr. Hamling for future screenings until she graduates from his care.