On January 2, 2025, Debra Hersom received the call no one wants to get. Her physician, Matthew Bobel, MD, FACS, a board-certified colon and rectal surgeon at St. Mark’s Hospital, relayed her diagnosis: she had anal cancer. Just a couple of weeks later, she began radiation and chemotherapy.
The 65-year-old woman from Cottonwood Heights shares that the cancer was caused by human papillomavirus, or HPV. The best prevention is vaccination, typically recommended for children. However, that was never an option for Debra.
"I think at first, I was in shock and determined to beat it. Then, I was angry because I wasn’t given the opportunity to get immunized because of my age," she explained.
According to the American Academy of Pediatrics, the Food and Drug Administration (FDA) approved licensure of the first cervical cancer vaccine in the U.S. in 2006. Licensure was granted for 9- to 26-year-old females to receive a three-dose series, and the target age for routine immunization was determined to be 11- to 12-year-olds.
In 2026, the HPV vaccine is widely recommended for adolescents to protect against several types of cancer as it has been proven effective. In fact, HPV infections and cervical precancers have dropped since the vaccine was first used. However, the FDA does not routinely recommend or approve the HPV vaccine for all adults 45 and younger.
Debra says knowing her physician’s reputation as one of Healthgrades’ "20 best colon and rectal surgeons near Salt Lake City" gave her hope and comfort in the care she would receive. She was committed to fight cancer.
"My family is amazing and has been my support and source of strength throughout this journey," Debra said. "For example, my sweet husband loaded up an old digital frame with a few hundred photos and videos of our travels and beautiful grandchildren to take to St. Mark’s Hospital to help me through the darkest times."
She didn’t realize it at the beginning, but Debra would become one of the first in the U.S. to undergo an abdominoperineal resection (APR) using a single-port robotic surgical system. The new approach to a historically morbid surgery could dramatically decrease her post-surgical healing time, pain, and risk of infection.
"Whatever was required," Debra said. "I just wanted to live."
Until the U.S. Food and Drug Administration (FDA) cleared the Single-Port (SP) surgical system for transanal local excision/resection in May 2025, which extended single-port capabilities in colorectal surgery, typical uses of the SP robot system largely included urological procedures; namely prostatectomies and kidney surgeries. The system was approved for urology use in 2018.
Life-changing, single-port APR surgery
Abdominoperineal resection (APR) is a major surgery that involves removing the anus, rectum and part of the colon, and then creating a permanent colostomy. In other words, as Dr. Bobel sometimes describes it to patients, "I remove your butthole then give you a Barbie butt and a poop bag."
Because APR requires the removal of the anus, the colostomy bag now functions as the source and site of defecation to eliminate feces from the body.
An APR is commonly approached in one of two ways: either one large incision on the abdomen or multiple small incisions. Every patient that undergoes an APR will also have an incision for the colostomy and a surgical drain.
The single-port approach to the colorectal surgery significantly reduces the number of incisions needed for this complicated procedure.
"Instead of five to seven incisions, I only had two," says Debra. "Instead of waking up with all these painful incisions on my stomach – which would mean that I couldn’t use my stomach muscles to sit up or do anything until they healed – I had no pain. The only pain I ever had was from the stitches. No stomach pain — that’s a game changer."
On Sept. 8, 2025, Debra was scheduled for a 6-month follow-up biopsy to determine whether chemotherapy and radiation had successfully cured her anal cancer. Unfortunately, it did not. The biopsy demonstrated residual cancer and the next step in treatment was APR surgery.
Dr. Bobel discussed Debra’s case at the multi-disciplinary tumor board at St. Mark’s Hospital – a uniquely beneficial feature of the hospital’s National Accreditation Program for Rectal Cancer (NAPRC) status — and scheduled her APR surgery for Sept. 25. As one of the only hospitals in Utah with the robot needed to perform the procedure, St. Mark’s had the resources to support the groundbreaking operation.
"I’m honored that the relationship that Debra and I developed over the last year enabled us to embark on this SP APR journey together. The new robot and my surgical team at St. Mark’s Hospital made it possible for me to use the fewest and smallest incisions possible to safely remove the cancer," Dr. Bobel explained. "It is common for patients to be fairly immobile for a couple days after having an APR. When I saw Debra the next day, I was truly amazed by how well she was moving around. I am excited that this procedure improved Debra’s experience, and I expect it will do the same for future patients."
Debra shares Dr. Bobel’s sentiment.
"We have been blown away by this surgery," Debra said. "Single-port robotic surgery for APR is going to make a huge difference for people because it makes healing faster."
Debra says that in many ways, she feels better than before her cancer diagnosis.
"I’m starting to see a true end to this whole thing," she admits. "I’ve loved working with Dr. Bobel and his amazing team, and I’m so grateful that he felt I was a good candidate for this single-port surgery. Within three months I was feeling better than I had since before the diagnosis and I continue to get stronger every day."
Home away from home
Following her surgery, Debra spent four nights at St. Mark’s Hospital.
"I could have gone home after three nights," Debra said. "But I’m glad I stayed because I was able to have one more session with the ostomy nurse, and we figured out an issue I was having with my pain medication."
Debra says that every nurse who cared for her not only anticipated her needs, but also really thought about what those needs were.
"I asked a patient technician for some hot water, and when they saw I was using it to fill my tea mug, next time they just filled my mug with the hot water," she says. "The second night I was there, I asked for an ice pack to sit on, but because people who have this type of surgery are not usually up and about, they didn’t have one that would work. One of the nurses had just had a baby and she knew the ice packs in labor and delivery would be perfect, so she went to the Women’s Pavilion and got some. And then there was Drew — a big veteran with gentle hands and the best stories to make you feel comfortable. It really was a home away from home."
Debra is also thankful for the ostomy nurses who teach patients how to care for their ostomies after they return home.
"The ostomy nurses calm you down," she says. "This is a really weird thing that you’re doing to your body. The nurses all believe in what they’re doing and that it makes a difference, and they’re correct."
More than one year since her diagnosis, Debra is busy getting back to her life, surrounded by her loving husband and mother.
"I’m doing better every day and look forward to having more energy," she said, smiling.
NAPRC Accreditation
St. Mark’s Hospital is the first and only hospital in Utah to receive the National Accreditation Program for Rectal Cancer (NAPRC) from the American College of Surgeons, raising the level of care for rectal cancer patients. NAPRC accreditation, through the American College of Surgeons, is a rigorous national standard that recognizes programs delivering high-quality, multidisciplinary rectal cancer care.
The accreditation is the gold standard of care for rectal cancer. It differentiates St. Mark’s from other facilities by demonstrating an advanced level of expertise, coordination, and accountability, which directly impacts patient outcomes and access to comprehensive care.
To achieve voluntary NAPRC accreditation, a rectal center must demonstrate compliance with the NAPRC standards addressing program management, clinical services, and quality improvement for patients. Centers are required to establish a multidisciplinary rectal cancer team that includes clinical representatives from surgery, pathology, radiology, radiation oncology, and medical oncology.
Additionally, the program met standards addressing the clinical services that the rectal cancer program provides, including carcinoembryonic antigen (CEA testing), magnetic resonance imaging (MRI), and computerized tomography (CT) imaging for cancer staging, which allow patients to start treatment within a defined timeframe. Rectal cancer programs accredited by the NAPRC undergo a site visit every three years and are also accredited by the American College of Surgeons Commission on Cancer.