It's all about the cancer
It Has Taken A Century For Americans to even notice the Tour de France. The punishing 2,000-plus-mile bicycle race--in which swarms of cutthroat superathletes soar up and down the mountains and back roads of France in the scorching July heat--is one of the most mentally and physically demanding of all sporting events. But it's a hard race to follow: Not only are the rules complicated, but much of the event's passion is lost in the news snippets that rarely air live here. Lance Armstrong changed all that when he became only the second American to win the race. And he won it magnetically as a discounted, cancer-surviving underdog.
The gutsy Texan was sidelined at age 25 by testicular cancer that had spread to his lungs and brain. The inescapable drama of this young man falling into the pits, being written off by his sponsors, struggling to survive, only to be reborn on his bike better than ever, is the stuff that Americans love. But this medical Horatio Alger offers far more than a feel-good portrait. Look closely and you see two key elements of successful patienthood when dark clouds loom: an aggressive intellect and indomitable spirit.
Taking charge. Lance Armstrong barely earned a high school diploma, yet he used brains, not brawn, to face those shocking three words: "You have cancer." He devoured reams of medical information from the Internet and other sources and learned the nitty-gritty of his own disease. Within days of his diagnosis, he and his equally spunky mother had appointments at two "Best Hospitals" experienced with his tumor. He chose Indiana University Hospital doctors because, while they pulled no punches about the seriousness of his cancer, they also proposed to modify his treatment to get him "back on the bike." For example, he and his doctors chose surgery to remove two grape-size tumors from his brain--rather than radiation therapy, which often brings memory and balance problems. And for his chemotherapy, they dropped one of the standard time-tested drugs, bleomycin, because of its pulmonary toxicity, thus protecting his renowned lung capacity.
Everyone has unique flash points for life after cancer, and personalized decisions are not just an Armstrong thing. The Internet is replete with reliable medical sites like the National Library of Medicine's PubMed and the Web sites of the National Cancer Institute and the American Cancer Society. It's worth the hunt. Just last week the Pew Internet and American Life Project released a new study indicating that 80 percent of Internet users seek health information, and for most of them it has made it easier to converse and negotiate with their doctors. Inevitably this brings a sense of personal control at a time of great vulnerability. For cancer patients, this is therapy in and of itself.
One cannot underestimate how debilitating cancer and its long months of treatment can be, both physically and mentally. When sturdy muscles melt away and grinding fatigue interferes with everyday tasks, it's easy to get discouraged, even depressed. But what's not so obvious is that the body and the mind powerfully benefit from the right attitude. That means no wallowing. The winning mind-set has faith that one can fight off the nasty cancer cells, appreciation of the importance of emotional support, and determination to get back on the bike and win a few Tours, so to speak. Our minds can't cure cancer,but the right attitude improves the odds. Indeed, that idea is the foundation of an emerging field, called psycho-oncology, which offers cancer patients treatments such as talk therapy, social support groups, and relaxation exercises like yoga and guided imagery. This is not New Age gobbledygook. Depression takes a toll on the immune system, especially on the natural-killer (NK) white blood cells that help fight off cancer invaders. A growing body of research shows that psychological therapies can strengthen the immune system and rev up those NK cells, and in some cases prevent relapse and prolong life.
In his intimate medical autobiography, It's Not About the Bike, it's clear that Lance Armstrong always chose hope: "Fear should never fully rule the heart, and I decided not to be afraid."
This story appears in the July 28, 2003 print edition of U.S. News & World Report.