In the elusive quest for “personalized” cancer treatments based on pharmacogenomics, diverse challenges must be overcome: questionable validity of “molecular models of life,” obstacles to bidirectional translation of scientific advances from bench to bedside to community, and limitations of bioinformatics to recognize and deal with “ignoramics/ignoromes” (expanding unknowns in cancer biology, theranostics, and therapeutic choices). These considerations apply to lymphatic system functioning—lymphatic vessels, lymph, lymph nodes, and lymphocytes—in diseases like cancer. J. Surg. Oncol. 2011;103:501–507. © 2011 Wiley-Liss, Inc.