IN OCTOBER I WAS TO MEET INTERNATIONAL CYCLING STAR Lance Armstrong at his posh West Austin home around three o’clock for a most uncomfortable interview. He would be answering questions not in his role as America’s most celebrated road racer but in his newer, less familiar persona: as a victim-spokesman for cancer awareness.
Just two weeks before, one of Armstrong’s testes had been removed after doctors discovered that he had advanced testicular cancer. The disease was in the “third stage”—meaning it had metastasized, or spread, from the testicle to his abdomen and lungs—so after the surgery, doctors had placed him on an aggressive chemotherapy treatment. They had given him a 65 to 85 percent chance of full recovery. Armstrong, displaying the stoicism and grit that had made him a world-class athlete, immediately announced that he would become a spokesman for awareness of the disease. As has become public ritual with suddenly stricken celebrities, Armstrong’s fans were first stunned that a 25-year-old at the apogee of physical conditioning could have cancer, then they were reassured, even buoyed by his resolute promise to lick the disease and help other young men do the same.
But when Stacy Pounds, an assistant to Armstrong’s lawyer, met me at the door, bad news was written all over her face. Apologizing profusely, she said Lance would be unable to do any interviews—now or in the foreseeable future—because some “troubling” news had arrived just an hour before from the M. D. Anderson Cancer Center in Houston. She wouldn’t go into detail, but it was clear that oncologists had recommended some changes in Armstrong’s treatment, which meant that something unexpected must have turned up in his blood work. For the time being, the would-be spokesman had to take orders from his disease, and simply wait. “It has thrown everything up in the air,” Pounds concluded, her voice taut with concern.
As it turned out, the cancer had spread farther than first believed, and later that month he underwent surgery at Indiana University Hospital in Indianapolis to have two lesions removed from his brain. The operation was successful, but for Armstrong, it was one more savage bump in the steep downhill course he had been on since the diagnosis. Earlier this year, he was riding high as professional bicycling’s brightest rising star. The young rider, who grew up in Plano, had begun to make his name in 1991, when he won the U.S. amateur championship, and continued the next year, when he had a strong showing in the Olympics. In 1993 he turned pro, racing internationally with the Motorola team, and quickly came into his own, winning that year’s world championship in men’s professional road racing, the Tour DuPont in 1995 and 1996 (the most prominent American cycling event), and stages of the Tour de France in 1993 and 1995. This past summer, one poll ranked him first in the world, even though he had dropped out of the 1996 Tour de France because of a respiratory ailment and had finished a disappointing twelfth in the summer Olympics. He had just signed an endorsement deal with Nike and a two-year, $2.5 million contract with a new French cycling team, Cofidis, and he had just moved into a new $1 million Mediterranean-style home on Lake Austin. Though in the States Armstrong is known almost exclusively by serious followers of his sport, he is extremely popular in Europe, where cycling, like track and field, has a much larger and more established fan base. He was, by all accounts, at the top of his game, an odds-on favorite to win the 1997 Tour de France.
But in September, Armstrong began to notice pain in one of his testicles. Such discomfort wasn’t in and of itself extraordinary for a man who makes his living riding a bike. Spitting up blood was, though; so in early October he visited his doctor and, for the first time he could remember, had his testicles checked. Thus began the roller coaster ride that has once again turned Lance Armstrong’s life upside down. It’s hard to imagine a psyche that could be more shocked by the idea of a life-threatening illness than that of a youthful, vigorous athlete. If cancer is difficult for most of us to contemplate, it must be an impossible abstraction for a man like Armstrong, whose entire life has centered on the fine-tuning of his body, on the acute awareness of its every ache and pain and weakness. Like most athletes, he had learned to live with a certain level of constant pain, and yet he had also continued to push his body harder. Each time he found out that he could take greater strain, it perhaps re-inforced a belief that his body would never let him down.
Certainly he never imagined that he might have testicular cancer. Though the disease is relatively rare, afflicting fewer than 4 out of every 100,000 men and accounting for 1 to 2 percent of all male cancers, it has quietly become the second most common cancer, behind leukemia, among males between ages 18 and 35. It has remained in the shadows because, as Armstrong’s Austin oncologist, J. Dudley Youman, puts it, “a twenty-five-year-old isn’t going to think of getting cancer.” Perhaps more important, it involves a region of the anatomy so private and sacred that most men feel uncomfortable inspecting themselves there or even entertaining the thought that something might be wrong with it. Armstrong, for example, said publicly that he believes he has had one enlarged testicle “ever since I can remember.” But until the enlargement became painful, he apparently never gave it a second thought.
The good news about testicular cancer is that, stealthy as it is, it responds well to chemotherapy. Its malignancies are among the fastest-growing cancers, and cells that replicate quickly are much more susceptible to chemical assault than slow-growing ones, such as colon cancer cells. (This is why chemotherapy patients commonly lose their hair during treatment: Hair cells grow faster than nearly all others, and chemotherapy makes