Work in Sports
Tour de France winner Lance Armstrong used a triumphant whirlwind return to the U.S. to peddle a message of hope
By Leigh Montville
The television interviewers were stacked up on the satellite feed like so many planes above La Guardia on a stormy day. The producer from NY1 in New York was still signing off as the reporter from KTBC in Austin started asking Lance Armstrong questions, as the producer from KCBS Sports Central in Los Angeles was making sure he would have Armstrong on in eight minutes, as Diana Nyad of Fox Sports News waited, followed by Jim Rome of The Last Word, followed by.... "I feel almost guilty doing this to him," said Mike Leventhal, a producer for Bader TV News, where Armstrong sat for the interviews. "I usually space things out, give somebody a rest between interviews -- just 30 seconds to have a drink of water or something -- but there just isn't time."
No matter. This was what Armstrong wanted to do during his 21-hour visit to the U.S. last Thursday. He sat in front of TV cameras most of the day and told his story again and again. He had begun his rounds on CBS This Morning at 5:45 a.m., having arrived in the wee hours from Holland aboard an executive jet chartered by Nike. He would end the interviews at nine in the evening on David Letterman's couch, as a limo waited outside the studio to take him back to the jet, which would take him back to Holland.
This was Armstrong's opportunity for public conversation. He would make people laugh. He would make more people cry. He would blanket the country as best he could, talk to everyone -- anyone -- taking advantage of the moment before the expiration date arrived, before the easily distracted public eye moved to some other grand feat or terrible disaster, some other curiosity.
He was the man who had won the Tour de France. He was the man who had kicked cancer's ass, choosing riskier, more agonizing therapies so he could protect his future as a cyclist even while his life hung in the balance. And he had a message to deliver. This was his moment to speak, and he would not let it go. "If I can save five lives by going on some show, it's worth it," he said. "If I can save one life by going on all the shows, it's worth it. I'm prouder of being a cancer survivor than I am of winning the Tour de France. Believe me."
His story is a modern parable of hope. How many people have heard the word cancer in a doctor's office and felt a chill? How many people are going through chemotherapy or radiation, sitting at home, wondering what will happen tomorrow and the tomorrow after that? Armstrong is one of them, part of this multitude of the damned. He always will be. "I'm aware of the cancer community wherever I go," he says. "I could feel it at the Tour. People would come up to me before races or after races. I could feel it during the races. It's a community of shared experience. If you've ever belonged, you never leave."
On Oct. 2, 1996, Armstrong's doctor told him he had testicular cancer. Armstrong was 25 years old, the best bicycle rider in the U.S., a former world champion -- confident, abrasive. He'd never thought about cancer. Not once. The uncomfortable bump on one testicle certainly was somehow the result of cycling, he told himself. The blood that he spit up, well, that only happened once. The diagnosis was a shock. "I thought the same thing everybody thinks when he hears the word cancer," Armstrong says. "I thought, Oh my god, I am going to die."
He not only had cancer; he had an advanced case. The removal of a testicle on Oct. 3 was only the start. A few days later he was told that the cancer had spread to his lungs, which were rife with tumors. A short time after that he was told that the cancer had spread to his brain.
After the surgery in Austin, he went on the Internet, punched in the words testicular cancer and was surprised at how much information the search engine brought home. He consulted with other doctors. He eventually landed in Indianapolis, at the Indiana University Medical Center, being treated by medical oncologists Lawrence Einhorn and Craig Nichols, the U.S.'s top testicular cancer specialists.
If Armstrong had arrived at a doctor's office in this condition 25 years ago, he almost certainly would have died. Brian Piccolo, the Chicago Bears running back whose story was chronicled in the movie Brian's Song, died of testicular cancer in 1970. Armstrong's chances were much better now due mainly to the work of Einhorn, who had perfected a chemo treatment that had greatly reduced deaths, but he was still in trouble. "The chemo works or it doesn't work," Einhorn says. "If it works, the patient will live a normal, cancer-free life. If it doesn't and the cancer comes back, he usually will be dead three to four months later.
"I didn't know who Lance Armstrong was. It's funny, too, because I really follow sports. Football, baseball, basketball. I just didn't know anything about cycling. I thought, O.K., a cyclist. I've had athletes before -- testicular cancer is a disease that strikes young men. Then I started receiving these calls and E-mails from oncologists around the country, around the world. I realized this was someone special."
There are choices with all treatments. After examining Armstrong, the doctors devised a course of treatment for him. The primary goal was survival. The secondary goal was to allow Armstrong to resume cycling. Einhorn and Nichols laid out choices that would make the resumption of an athletic career possible.
"There were two major decisions," Einhorn says. "The first involved the brain tumors. Chemotherapy doesn't work as well on brain tumors for some reason. We don't know why. The standard treatment is radiation, but one of the effects of long-term radiation is a slight loss of balance. Not enough to affect the average person, but certainly enough to keep someone from riding a bicycle down the Alps. We chose surgery instead of radiation for Lance. It's slightly riskier, but he had only two tumors and they were in a position where a surgeon could get to them.
"The second decision was on the chemotherapy itself. The drug we usually use is bleomycin, which produces less nausea, vomiting and other side effects than ifosfamide, another possibility. One downside of bleomycin is that it slightly diminishes the patient's lung capacity. Again, for the average person, this would not be a problem. But for a cyclist? Lance chose the ifosfamide, taking the short-term discomfort for the long-term gain."
The brain surgery was performed on Oct. 24. The chemotherapy was administered in three separate five-day stretches. Armstrong would come to Indianapolis for a treatment, return home for 2 1/2 weeks, then return for another treatment. His hair fell out. He lost between 10 and 15 pounds of muscle -- he had nothing else to lose, since he had begun the treatments with less than 2% body fat.
Armstrong's hope had been that his athlete's physical conditioning, even his focused, positive athlete's mind, would be his greatest ally. Cancer doesn't work that way. The weak survive as often as the strong. The strong succumb as often as the weak. The athlete's body and mind were not factors. "I've had wonderful, positive people, people who ate all the right things, did all the right things, not make it in the end," Einhorn says. "It just a shame. There's no correlation. I've had some of the most miserable, ornery people, complaining all the time, survive to resume their miserable, ornery lives."
Einhorn's first indication of success was a clean chest X-ray. A dead tumor in a lung can remain in the picture for a year, indistinguishable from a cancerous tumor. The tumors have to disappear from the X-ray before the doctor knows they're dead. This happened for Armstrong in April 1997.
The second benchmark was a blood test, tracking a factor called the HCG count. A normal HCG count is 1.5 or less. Armstrong's was over 100,000 in the beginning. It had to return to 1.5 and stay there. The count dropped to normal in February 1997 and stayed there. When it was still normal in October 1997 -- one year after Armstrong's first chemo treatment -- he was pronounced cured. He had beaten cancer. "He's no more susceptible now to other cancers than anyone else," Einhorn says. "The testicular cancer will not return. He's clean. In a world filled with sad stories, Lance's is a wonderful story."
The second half of his story is almost as startling as the first. Armstrong never really left cycling -- he took 30-mile rides in Austin during the recovery time between chemo sessions -- but as he returned to full-time riding, he gradually found that he was even better than he had been before he became sick. The weight loss from the chemo had left him with a lighter and even leaner body. The experience had left him with a different mind. He was more mature, more serious, more directed.
He got married. His wife, Kristin, became pregnant in vitro with sperm he had frozen before he started the chemo. He looked at all the possibilities. He looked at the Tour de France.
"The doubt about him had always been the climbs in the mountains," says Armstrong's friend Jim Ochowicz. "He always could sprint well, and he always was capable of winning a stage in the Tour. The mountains were his downfall. But with the weight loss -- if you lose five pounds, that's a large weight loss for the mountains. It was all he needed. He became very good in the mountains."
After Armstrong finished fourth in the Tour of Spain last September and then fourth two weeks later in the one-day world championships, he decided he had the necessary stamina for France in July. For the first time in his career, he spent the spring in Europe, training for the race. For the first time, with his U.S. Postal Service teammates, he practiced on the same steep roads through the Alps and Pyrenees that he would have to ride during the race. For the first time, the Tour really meant something.
On July 3 he won the prologue, the opening stage, and donned the yellow jersey as the leader of the race. On July 11, after losing the jersey, he regained it by winning a time trial in Metz. The next day he took control of the race by decisively winning the first of the Tour's grueling stages in the Alps. For the ensuing two weeks, surrounded by American teammates, riding an American bike, the 27-year-old American kept the jersey. He rode through scurrilous drug allegations (box, page 71) and sunshine, through mountains and rain. He rode all the way to Paris. All the way to the victory stand on the Champs-Elysees.
And all the way into homes across America. "If I never had cancer, I never would have won the Tour de France," Armstrong said into the camera last Thursday, four days after his win. "I'm convinced of that. I wouldn't want to do it all over again, but I wouldn't change a thing.
"I'm talking to you today, but I'm not sure how. I know some things about cancer now. I know you have to pay attention, to watch for signs on your body, then react. I know you have to do research, go on the Internet, look for the second opinion, then the third, find out all your options. I also know you have to be lucky. That's probably as important as anything. I was very lucky."
"If I never had cancer, I never would have won the Tour de France," said Armstrong. "I'm convinced of that."
Issue date: August 9, 1999