I also feel that Tiffany's case is not that special or hectic, at least not in a way that she is portraying - that they don't know what to do with her. Of course doctors knew what to do with her, the surgeon told her about pelvic exenteration a very long time ago. He knew that was the most likely outcome even before she completed radiation. He already had an idea from experience and from seeing how her tumour was behaving after chemo.
On the other hand, from what I have read and heard, pelvic exenteration is a rare outcome of colorectal cancer (or any cancer, such as cervical). Papers talk about PE as a last resort treatment, when nothing else has worked. It is not a go to treatment, it is not common. So in this aspect she is rare. Most colorectal patients have a much less invasive surgery, even at stage 3 (e.g. Vanessal Lopez). Most patients have parts of their colon and/or rectum removed and that's it. Even if they get a stoma, it is usually temporary (to let the bowel rest whilst they are receiving other treatment or after surgery). Tiffany's tumour was invading most of her pelvic organs, the cancer was more advanced than others'. Yes there are more advanced colorectal cancers than hers (with distant metastases, such as to the lungs or the liver).
Is Tiffany's cancer primary or recurrent?
One paper says "Pelvic exenteration is very rarely performed for primary disease as the definitive treatment." Tiffany's cancer is primary as far as we know? I know that Nat's is "recurrent" so her PE was probably performed for that reason (and because of how advanced it was). Or is Tiffany's cancer recurrent? She implied no cancer cells (we don't know about the T4b tumour) back in July/August and then a month ago or so her and Darling said that the "cancer was back/cancer has grown" - would this be considered as a recurrent cancer?