INDIANAPOLIS — A pro athlete fighting an advanced case of testicular cancer recently came to Indiana University’s Simon Cancer Center, encouraged by a message from Lance Armstrong. It is not clear how Armstrong knew about the patient, or about the cancer
The incident was not made public. Larry Einhorn, one of the oncologists who treated Armstrong for testicular cancer in 1996, said the cyclist interacts with such patients all the time, even if merely by text. No photo ops. No publicity.
No athlete has done more for the cancer community, Einhorn asserted.
“That’s the part of Lance that people don’t know,” he said.
There are many parts to Lance Armstrong. The first part of a “30 for 30” documentary on his life was televised last week on ESPN, with the second scheduled for tonight.
Einhorn, who revolutionized treatment for testicular cancer, is a distinguished professor of medicine at the Simon Cancer Center.
In 1996, Armstrong was also treated in Indianapolis by Craig Nichols, director and founder of Testicular Cancer Commons and an executive officer of the Southwest Oncology Group. Coincidentally, Nichols now lives a mile from Nike headquarters in Beaverton, Ore., where Nike removed Armstrong’s name from its fitness center.
Neither oncologist was interviewed for the ESPN documentary. Both watched.
“I’ve always told Lance, even when he was winning seven consecutive yellow jerseys, that his legacy will not be his athletic prowess, but what he has done for the cancer community,” Einhorn said.
Armstrong, 48, was stripped of his seven consecutive Tour de France victories (1999-2005) after long-held suspicion of his doping was confirmed. Before that, he was an icon who transcended sport, a cancer survivor and role model.
In the documentary, he acknowledged he will be an object of scorn for the rest of his life. Attacks against him often cite the bullying tactics he used to discredit whistleblowers.
“They are pissed still. And they will be pissed forever,” Armstrong said.
The busted myth
Nichols told IndyStar he was “as disappointed as anyone” by revelations of Armstrong’s use of EPO, an endurance booster. Nichols also said that among cancer survivors who have wealth or celebrity, Armstrong did far more than most. Armstrong started a foundation in 1997 that became known as the Livestrong Foundation, which supports cancer survivors. Livestrong yellow bracelets became ubiquitous.
“I think the myth he promulgated was far less important than the myth he busted,” Nichols said.
The busted myth, the oncologist said, was that those with testicular cancer cannot survive. Or have a meaningful life. Or have children. (Armstrong is a father of five, all born since 1999.)
“That, for me, was the enduring value that he brought to the field, and brought hope and energy and money for basically a worldwide reform in how we take care of those between age 15 and 40 with cancer,” Nichols said. “I don’t think any of that would have happened if he had said, ‘Thank you very much. I’ll come back for my follow-ups. See you later.’
“What his motives were, I don’t know. It turned out good.”
What researchers have learned since 1996, Einhorn said, is that someone in Armstrong’s condition then (high-risk phase 3) had about a 30% chance of surviving. It was “never true,” Nichols said, that chances were as low as 10%. The oncologist said Armstrong did not dwell on that anyway.
“The tumor marker was the scoreboard. It was a game to me,” Armstrong said in the documentary. “But it was a game of life and death.”
Even fatigued by chemotherapy, Armstrong continued on his bike, riding 30 to 50 miles a day between sessions. It was “almost superhuman,” Einhorn said in a 1996 interview.
Armstrong said he was 21 when he began using performance-enhancing drugs. He said the only year he used human growth hormone was 1996, and he speculated that contributed to testicular cancer.
Nichols said that would have had nothing to do with it.
“And plus, it didn’t matter,” he said. “We just had to get him well, not figure out how he got it.”
Nichols said researchers never thought testicular cancer was something “you could smoke yourself into, eat yourself into, or drug yourself into, even in the ‘90s.” He said genetics play a role and that the disease is more common in those of northern European or Scandinavian ancestry. The last name of Armstrong’s biological father is Gunderson, a surname of Norwegians and Swedes.
Nichols said the average age of diagnosis for testicular cancer has dropped since 2000, and he credited Armstrong for raising awareness. The oncologist said Armstrong has continued to travel to Indianapolis annually to be tested for long-term consequences of treatment in an attempt to help other survivors.
During one of Armstrong’s legal battles was a Dec. 8, 2005, affidavit signed by Nichols stating the cyclist’s medical file did not contain any admission of PEDs. The affidavit said Armstrong’s blood levels from 1997 to 2001 showed nothing irregular.
The case involved SCA, an insurance company that promised to pay Armstrong a $5 million bonus if he won his sixth straight Tour de France in 2004. Witnesses for SCA said they were present in the hospital in 1996 and heard Armstrong admit to doctors he had used PEDs.
The cyclist eventually received a $7.5 million settlement.
Einhorn acknowledged he didn’t “think anyone was smart enough” to pass all the random drug tests taken by Armstrong over the years. There was so much doping, Nichols said, that Armstrong won his Tour de France titles on a level playing field.
IU’s cancer center continues to be “the Lance Armstrong of testicular cancer,” Nichols said. “Except for the cheating part.”