When my bariatric surgeon was counselling me prior to having my open RnY in 2002, the main thing he stressed to me was that if I ever got cancer, my chances of survival were next to 0 due to the nutritional factors dealing with cancer.  Nobody knew that my WLS would cause me to eventually start having problems with malnutrition.  And most certainly, nobody ever expected my surgery to cause me to end up with APL leukemia!

APL is a very rare form of leukemia.  If you'd like to read more about it, here's a link (https://ghr.nlm.nih.gov/condition/acute-promyelocytic-leukem ia#) or you can google it and find out even more.

APL is caused by a genetic mutation.  In my case, this mutation was caused by a severe vitamin A deficiency that I wasn't aware I had.  I knew I had problems with microcytic anemia and pernicious anemia.  I'd suffered a light stroke due to these two anemias.

I learned that not every gastric bypass patient will have the same results.  Some of us end up having other forms of health problems.

I found out I had APL after I was injured on the job and cut my head open, which required staples and a tetanus shot.  The morning afterwards, my entire left arm was deep purple from the injection.  The following week, when I went back to the ER after work to have my staples removed, I showed the ER physician my bruise and he wanted to know if someone had been beating on me.  When I explained that it was bruised from the tetanus shot, he started testing me.  About 45 minutes later, he took me into a private room to break the news to me that I wouldn't be going back to work and why.  He told me I had to go to UVA to start chemo and blood transfusions.

I wasn't even allowed to go home that evening to prepare for my trip to UVA.  I wasn't allowed to leave the hospital.  At the time, I really didn't understand why, but eventually I would learn.

APL is a fast acting form of cancer.  I was told that 20 years before I got it, everybody who got it was pretty much handed an automatic death sentence because they died from internal hemorrhaging within a month of onset of the disease.  But luckily for me, by the time I got it, they had developed the drug ATRA (all-trans retinoic acid).  ATRA is a mega-dose of vitamin A and it is the main drug of choice for treating APL.  It is very expensive.  At the time I took it, I had to take 5 capsules with breakfast and 5 capsules with dinner every single day.

After I took my first dose of ATRA, I had what they called "ATRA syndrome" and ended up on a ventilator for about a week.  It didn't matter.  I still had to take the ATRA.  The cost of my ATRA alone was over $1,800/month.  Also, there were only 2 patients in the state of Virginia when I was diagnosed.  I was one and another lady in Chesapeake, VA was the other.

I didn't understand how long I'd been sick or what had happened to me and I was very persistent in talking to my oncology doctors and asking questions.  I wanted to know how long I'd been sick with my leukemia.  The response I kept getting was, "Not long!"

Of course, when I had my surgery, Very little was known about the risk factors associated with WLS.  Nobody ever mentioned or even thought about the surgery causing my APL.  The medical world really doesn't know everything about the affects of APL yet, but they're learning.

I looked on ObesityHelp for answers and found none pertaining to my gastric bypass surgery.  There was nothing listed on leukemia at all that I could find.  I saw posts about breast cancer, thyroid cancers, and other forms, but not one on leukemia.  I thought this needed to be something that other patients need to be aware of as many possible types of illness that can occur after WLS.

I wish you well in your journey!

Robin~

In  June 2010 I had gastric by pass surgery. Did very well with my surgery, when the Dr. came out and told my family how well I had did, he did say her spleen was enlarged, but this is not uncommon for obsess patients.  In February of 2011, I was diagnosed  with Non Hodgkin's Lymphoma, Stage 4 cancer. I had to have a splenectomy (2/2011), the cancer was in my spleen and bone marrow.  I took 6 months of chemo, regimen called "Chop" and I had no weight gain. Also one of my cancer drugs was prednisone, which cause some to gain weight.   I walked every day that I was able too. The day of and after my chemo I was so tried.   I wasn't able to eat that well, that may could have caused be not to gain, unsure!

As of Feb. 2016 It has been 5 years and with the good help of the lord I am cancer free. For my weight, so far so good. I guess I could stand to lose about 10 pounds. I started out at 289  (I am 5'4) and today I weigh 167.

I received a confirmation yesterday that both masses are cancer.  I have an appointment with a recommended breast surgeon this morning.  I know this is serious stuff but I can't help wonder what is going to happened with my RNY weight loss.

Weight gain during and after chemo is not unusual, particularly for breast cancer, and particularly for triple negative breast cancer.  I gained 16 pounds during chemo for Stage 3B breast cancer, most of that in the first two months, and another 11 pounds in the first three years after chemo. The gain is partly due to the retention of fluids during chemo, but also due to the really great anti-nausea drugs they give you.  If you can keep up the exercise that is great.  Do not give yourself too hard a time if you can't. Each chemo is cumulative in impact, and you will be a lot more tired as you go through the process.  When you are finished with chemo and recovery from chemo---which itself takes time, turn yourself over to a really great bariatric doctor and work on the weight later.  Right now, survive and thrive!  The extra pounds can be licked far more easily than a recurrence of cancer; your focus now must be to keep up your numbers on the blood work so you get a full measure of what you need at each chemo appointment.

My gyno found 2 nodules in my right breast during my yearly exam on Monday of this week.  I had a diagnostic mammogram w/ultrasound on Wednesday.  The doc did not like what she saw (2 masses + some lymph nodea) and scheduled me for a vacuum core needle biopsy w/ultrasound on Friday (yesterday).  She said that even if the biopsies come back negative that I will need to see a breast surgeon as the masses need to come out.

The elephant was in the room for sure.  I know by the conversation that she suspects I have cancer.  I am just 3 months out from having my RNY, how will chemo, radiation, and surgery affect my RNY progress?  What about the drugs I will possibly have to take, are there any I have to be wary of because of my RNY?

Any advice from anyone that found themselves in my shoes after having RNY?

Update morning of 2/29/16:  I got the electronic results of the mammogram and ultrasound that was done last Wednesday, it sounds ominous.  

"2 irregular hypoechoic right breast masses with right axillary adenopathy. Findings are highly suggestive of malignancy with metastatic adenopathy.
Final Assessment: Highly Suggestive of Malignancy- Appropriate Action Should Be Taken (BIRADS Category 5)"

I will be receiving the biopsy report sometime today.

Update evening of 2/29/16:  The radiologist did not receive the test results from the lab today.  They said hopefully they will come in tomorrow.  I'm a nervous hot mess right now.