The operation went well. I was lucky enough to get to hear Dr. Vargas tell Shelley, Shawn, Sherry and Pearl's mother that the surgery went well. He believes that all of the tumor was removed and that there was no spreading to other organs. The lymph nodes and tumor have been sent to the labs and the pathology report is expected no later then Tuesday. From that we will receive the prognosis and the staging information.

The tumor was large.

Roughly 9 inches of her large intestine were removed and the majority of her rectum, but he was able to successfully connect everything back together so she will regain full use of her digestive system in around 2 months. She has a temporary colostomy while everything heals. The mass was so large that although the radiation had shrunk the tumor down to basically nothing the outer mass had grown large enough to act as a clamp on her intestines.

Previously we had been informed that her small intestine had fallen during treatment and might have been burned by the radiation, but that was not the case. So she should not see any effects of that which is huge news, because that was a potential life long pain (unbearable to most of us) that she would of had to endure.

So you can understand what we are waiting on it is important to understand TNM Staging (and that metastasis = spreading).... for Pearl we know the T and M components.

TNM Definitions

Primary tumor (T)
T0: No evidence of primary tumor
T1: Tumor invades submucosa
T2: Tumor invades muscularis propria
T3: Tumor invades through the colon wall*
T4: Tumor directly invades other organs or structures

Regional lymph nodes (N)
NX: Regional nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in 1 to 3 regional lymph nodes
N2: Metastasis in 4 or more regional lymph nodes

Distant metastasis (M)
MX: Distant metastasis cannot be assessed
M0: No distant metastasis*
M1: Distant metastasis

Stage I
T1, N0, M0
T2, N0, M0

Stage II
T3, N0, M0
T4, N0, M0

Stage III
Any T, N1, M0
Any T, N2, M0

Stage IV
Any T, Any N, M1

* What Pearl has

Which gives us T3NXM0 so far, and stages the cancer as either II or III. From WebMD:

Stage II
Also called Dukes B colon cancer, the tumor extends through the muscular wall of the colon, but there is no cancer in the lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).

The 5-year survival rate for Dukes B colon cancer is 87%.

Stage III
Also called Dukes Stage C1 or Dukes Stage C2, the cancer has spread outside the colon to one or more lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Tumors within the colon wall are classified as Dukes Stage C1, while tumors that have grown through the colon wall, and have spread, are classified as Dukes Stage C2.

The 5 year survival rate for Dukes C colon cancer is about 55%. Patients with one to four positive lymph nodes have a higher survival rate than people with more than five positive lymph nodes.

So we are basically praying for a negative result for the cancer presence in the lymph nodes. But in either case she has the upper hand and statistics in her favor... and if you know me, you know how much faith I put in numbers... they are a pure language :) Plus I think my mom has St Peter himself taking a few minutes out of his day to offer up a prayer for Pearl.

All in all the doctor, Pearl, and the family and friends are pleased with yesterday. It was an excellent start to the road to remission.