Can Surgery for Meniscus Tear Spread Cancer Cells in Lymphoma Patients?

Will cancer cells spread during general surgery for conditions other than cancer?

Hello Doctor, my mother was recently diagnosed with a meniscus tear in her knee, and now she walks slowly, which affects her daily life.
She needs surgery to walk, but at the same time, she has also been diagnosed with lymphoma.
She has already undergone a bone marrow biopsy and is waiting for the results.
I would like to ask if these two surgeries can be performed simultaneously.
For my mother, the inability to walk is currently her biggest concern, even more so than the lymphoma.
However, the orthopedic doctor we saw today said that we need to treat the lymphoma first before addressing the knee issue, as there is a concern that cancer cells might spread.
My understanding is that lymphoma treatment can take a long time, which means frequent trips to the hospital.
Would this not worsen the meniscus tear? Therefore, I would like to know if it is possible to manage both treatments simultaneously.
Thank you.

Miss Sun, 20~29 year old female. Ask Date: 2024/06/07

Dr. Chen Sirong reply Oncology

Ms.
Sun / 29 years old / Female
Hello,
1.
May I ask if these two surgeries can be performed simultaneously?
A: Orthopedic surgery is an operation, while lymphoma is treated with chemotherapy, which does not require surgery.
2.
Is it possible to manage both treatment regimens at the same time?
A: After chemotherapy for lymphoma, white blood cell counts may drop, increasing the risk of infection.
Is it suitable to undergo surgery? If orthopedic surgery is performed quickly, chemotherapy can be postponed for 1-2 months.
However, will there be a risk of cancer spreading during this time? I recommend discussing this with a hematologist-oncologist, who can then coordinate with the orthopedic surgeon to schedule the surgery.
Wishing you a speedy recovery.
Taoyuan Hospital
Dr.
Chen Sih-Rong

Reply Date: 2024/06/07

More Info

When it comes to managing a meniscus tear in a patient with lymphoma, there are several important considerations to take into account. Your mother's situation is indeed complex, as she is dealing with both a knee injury and a diagnosis of lymphoma.
First, it's crucial to understand the nature of lymphoma and its treatment. Lymphoma is a type of cancer that originates in the lymphatic system, and its management often involves chemotherapy, radiation therapy, or targeted therapies. The treatment can be lengthy and may affect the patient's overall health, immune system, and ability to recover from other medical procedures, such as surgery.

Regarding the concern that surgery for a meniscus tear could potentially spread cancer cells, it is important to clarify that surgical procedures do not inherently cause cancer to spread. However, in patients with active cancer, there is a heightened concern about the timing of surgeries and the overall management of their health. The primary worry is that surgery could compromise the immune system, making it more difficult for the body to fight the cancer or recover from the surgery itself.

In your mother's case, the orthopedic surgeon's recommendation to prioritize the treatment of lymphoma before addressing the meniscus tear is likely based on a few factors:
1. Immune System Considerations: Surgery can temporarily weaken the immune system, which is particularly concerning for someone undergoing treatment for lymphoma. If the lymphoma is active, it may be best to stabilize her condition before undergoing additional surgical procedures.

2. Healing Process: Patients with cancer may have a slower healing process due to the effects of chemotherapy or other treatments. If she were to have knee surgery while still undergoing lymphoma treatment, the recovery might be more complicated.

3. Prioritization of Cancer Treatment: The oncologist may want to ensure that the lymphoma is under control before subjecting your mother to the stress of surgery. This is a common approach in oncology, where the focus is on managing the cancer first to ensure the best possible outcomes.

4. Risk of Complications: There is always a risk of complications with surgery, and in a patient with an active cancer diagnosis, the risks may be higher. The surgical team may want to avoid any additional complications that could arise from performing surgery while the patient is undergoing cancer treatment.

While it is understandable that your mother is experiencing significant discomfort due to her knee issue, it is essential to weigh the risks and benefits of proceeding with surgery at this time.
In terms of managing her knee pain and mobility in the interim, there are non-surgical options that may provide relief, such as physical therapy, pain management strategies, or the use of assistive devices like braces or crutches. These options can help improve her quality of life while she undergoes treatment for lymphoma.

Ultimately, the decision regarding the timing of surgery should be made collaboratively by her oncologist and orthopedic surgeon, taking into account her overall health, the stage of her lymphoma, and her personal preferences. It may also be beneficial to seek a second opinion if you feel uncertain about the proposed treatment plan.
In conclusion, while it may be frustrating to wait for surgery, prioritizing the treatment of lymphoma is a common and prudent approach in managing a patient with concurrent health issues. Open communication with her healthcare team will be key in navigating this challenging situation.

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