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SALT LAKE CITY — Shortly after his surgery to remove a colorectal cancer tumor in March, Tom Evans said his doctor came in and pulled out his phone.
"He's like, 'Do you care if I nerd out with you for a minute?'" he said.
Dr. Tae Kim, a colorectal surgeon with Intermountain Health, proceeded to scan through a three-dimensional model of Evans' pelvic area showing clearly where his tumor used to be. The doctor had used the model — a new technology called Iris — while sitting at a console maneuvering a robot to remove his tumor during a five-hour surgery.
"I'm just shocked in amazement. ... What a gift, what a great thing," Evans said.
Evans, 50, is a special education teacher at Brighton High School and a father of seven children who enjoys hiking and working in his wood shop.
He said the 3D model allowed his surgery to be more precise, which was important since his tumor was nestled between his bladder and colon. Evans said he was shocked by how quickly his recovery went.
Evans also learned that this model was new; he was the very first patient to have surgery with a doctor helped by the Iris software. He was out of LDS Hospital, Salt Lake City, about 48 hours later and said his recovery has been "remarkable."
Kim said rectal cancer is difficult to deal with in surgery because it is deep in the pelvis, and there is limited room. Evans' tumor recurred and was deep in his pelvis, involving the rectum, making the surgery one where the 3D map was very helpful.
"The more information you can get beforehand, the better," Kim said.
Evans is now "disease-free," and doctors are watching to make sure it doesn't return.
Before, Kim said he has referenced an MRI scan during surgeries, scrolling through images of various layers. Now, that scan is used to create a 3D image that can help him plan out the surgery even better and perform the surgery more quickly.
He said the 3D scan is like a map, and he can change the viewpoint to match the direction he is looking during the surgery. It allows him to move faster and know where he needs to slow down.
Kim said the biggest benefit of the new software is the cancer outcome. He said the best predictor of whether cancer will come back for colorectal cancer patients is how far past the cancerous tissue the surgeon removes — and this added visual helps him go further than he could before.
He said the 3D visuals can help him explain to patients what their surgery will be and why the doctor is making certain choices with their surgery. Kim said he has shown patients their MRI scans, but they don't engage with it. With the 3D image, they can actually understand and engage in the conversation about their surgery.
The visual can be easily modified, focusing on certain areas and graying out others to help the surgeon and the patient focus on what they are talking about.
Evans said when he first was diagnosed with cancer in 2022, it was an emergency. He received multiple surgeries before he was diagnosed. This time, there was a plan, and he was able to optimize his recovery by taking steps before the surgery.
Kim said the Iris software was first used for kidney tumors and is just starting to be used for colorectal cancers. He began working with Intuitive, which created the Iris software, as it began to develop its colorectal cancer protocols.
"I've been working with them since the very start because I know that this technology will help get better patient outcomes," he said.
Kim said the primary reason to not use this software on each patient is the cost — each model needs to be created from an MRI, and that service is billed to the hospital. But the doctor said he thinks the model is "invaluable for patient education," even if it is not needed to improve a patient's surgical outcome.
Since Evans' surgery, Kim said the hospital has used scans for about six other patients, but surgeons opt not to use it when the tumor is more accessible.
Evans encouraged people to get checked for colorectal cancer, whether they are active or not. He said the best time to focus on preventing disease and fighting cancer is now. It's easier to fight something you don't have.
"Don't be a statistic where something can be prevented. You don't have to have colorectal cancer," he said.
Kim said one in eight Americans will get colorectal cancer, but it is one of the most treatable cancers if it's caught early. He said people should get colonoscopies beginning at 45, or if they have seen a change in bowel habits or blood in their stool.
"Personally, I'd rather be out of the job. If everyone got screening colonoscopies and caught it before it turned into cancer, that'd be great. But thankfully, we have tools like this to help save people when they actually get cancer," he said.
