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In Defence of Lance…




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As this year’s Tour de France starts and we wonder if Chris Froome can take over from Sir Bradley this blog thinks about previous Tours with some sadness. As an oncologist treating testicular cancer the Tour used to be a reminder of one of the great successes of modern oncology. Seeing Lance Armstrong on the podium showed how chemotherapy can overcome even poor prognosis testicular cancer. Lance was an inspiration to our patients. I doubt there has been a happier sight on the chemotherapy day unit at Guy’s Hospital than seeing the young men cheer Lance as he surged past Jan Ullrich, whilst they were receiving their chemotherapy.

So rather than become too melancholy I thought I would use this blog to provide a little balance to all the stick Lance has been taking. Whilst Lance as a cyclist is tarnished forever, the other aspect of his story seems to have been forgotten. The incredible part is that he overcame such aggressive disease and was able to ride competitively. He should therefore remain an inspiring figure for those of us treating testicular cancer, and more importantly for young men battling this disease. Whilst as oncologists we quote impressive survival figures, for patients an example of someone who has survived is far more tangible.

So I have been re-reading ‘It’s not about the bike’ (how ironic that title seems now!). The chapters dealing with diagnosis, treatment and recovery are informative and remain inspiring. It’s easy to see why it became and could still be a touchstone for young men battling testicular cancer.

Whilst many will argue that Armstrong’s well publicised battle against cancer was just part of his ego let’s not forget that it takes guts in the macho world of professional sport to admit illness and potential weakness. Many famous men have been affected by cancer but all too often don’t feel able to talk about it or use their position in a positive way. Armstrong was the polar opposite, happy to provide inspiration and also to raise millions for his cancer charity. He also raised the profile of testicular cancer and the need for ongoing research and there remain many important unanswered questions in this disease:

  • Who need’s adjuvant treatment?
  • What adjuvant treatment should we give?
  • How to minimise toxicity of treatment?
  • Long term toxicity and survivorship issues
  • Why are some patients’ cisplatin insensitive?
  • The role of RPLND and metastatectomy
  • The best second line chemotherapy
  • And many others…..

TUF Cycling Across the Andes: More intrepid cyclists supporting research into urological cancers. For more information visit www.theurologyfoundation.org or www.actionforcharity.co.uk.

So as this year’s Tour de France winds its’ way towards those punishing Alpine stages perhaps we should draw a line and move back to Armstrong as the inspiration for the next generation of men with testicular cancer. I for one will always enjoy that ascent on Alpe D’Huez and how it shows we can over come even the worst disease. So Lance your boys still need you! It’s time to eat a very large slice of humble pie and rewrite the book, warts and all, so that you can be an inspiration to the next generation of men with testicular cancer.

Simon Chowdhury is a Consultant Medical Oncologist at Guy’s, King’s and St Thomas’ Hospitals, London. He is actively involved in clinical trial research into urological cancers.

 

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  1. Roger Kirby
    Nice blog Simon, and you really hit the mark with Lance, who has been an inspiration to so many men with testicular cancer. I remember reading and being inspired by his book "It's Not About the Bike" and I have recommended it to very many of my patients. Sadly, his accomplishments as a cyclist and his tribulations in battling against testicular cancer have been submerged by the scandal of the use of epo and other substances during the Tour de France, which he won so many times. The positive has been subsumed by the negative. A stark warning is there for us all!
    Simon mentions the Cycling Challenge in South Africa in November for TUF. Information about this is available on www.theurologyfoundation.org or www.actionforcharity.co.uk. We are dedicating this ride to the memory of John Anderson (https://www.youtube.com/watch?v=7a6gaSoGJoQ&feature=youtu.be) who sadly died recently from metastatic prostate cancer. Do join us in memory of John on what will be a fantastic adventure the proceeds of which will support education, training and research in our specialty.
  2. Amrith Raj Rao
    This article on raising testicular cancer awareness has been very timely for a snooker fan like me as, Ali Carter, two-time World Championship finalist has been diagnosed with testicular cancer this very week! (https://www.bbc.co.uk/sport/0/snooker/23129387).

    My interest in Lance Armstrong was due to the fact that I researched on the discovery of one of most successful chemotherapeutic drugs, cis-Platinum (presented at AUA 2012). Lance, who had metastatic testicular cancer was completely cured with the help of this drug and so has many others. Lance has been instrumental in raising the profile of testicular cancer and chemotherapy through his charitable organisation, that has touched the lives of hundreds and thousands of young men afflicted by testicular cancer.

    I end by urging Lance not to quit his support for raising the awareness of testicular cancer and reminding him of his own famous quote "Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever"!
  3. Simon Chowdhury
    Dear Roger and Amrith, thanks for your comments. There still remains a lot of research to be done in testicular cancer. Much of this work is being done in the UK and I would encourage everyone to continue supporting these important studies https://www.ncri.org.uk/csg/portfolio/Testis/Testis%20Portfolio%20Map.pdf
    Another amazing afternoon in the Tour with an Armstrong-Like performance from Chris Froome on an afternoon when wandering for an ice cream was an effort.
    https://www.guardian.co.uk/sport/2013/jul/14/tour-de-france-2013-chris-froome-stage-15

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