The 'Roid Report for the week of September 21

by Gary Gaffney, MD, Steroid Nation

In this installment of the 'Roid Report, we will focus on recent startling developments in pro cycling involving the sport's international, intergalactic celebrity Lance Armstrong. As everyone knows, Armstrong will be attempting a comeback from a 3 year absence from the pro cycling world. Armstrong won 7 Tour de France events, which is legendary in the history of the event. Unusual for American cyclists, Armstrong became more than a great cyclist he became the icon 'Lance Armstrong' who beat metastatic testicular cancer. Armstrong survived a toxic course of treatment, and a bone marrow transplant. Armstrong's children were conceived by stored sperm, as Armstrong was likely made sterile by the treatment ordeal.

The fairy tale story of 'man beats cancer' and 'man beats French', and 'man with nice family' seemed to be in place. Armstrong retired from professional cycling as possibly the most honored cyclist in history. He devoted his life to cancer awareness. The stuff of dreams, except for...

Rumors (or better) of Armstrong's doping. Frankly, the cycling peloton during Armstrong's career used tons of performance enhancing drugs, or more appropriate to the European vocabulary, doping. Steroids, blood doping and later EPO, cortisone, amphetamines, HGH, the gamut of PEDs would likely show up in most pro cyclist's blood stream or urine. Even one of the most hallowed cyclists -- Eddie Merckx -- tested positive for doping. How could Armstrong beat the best of the contemporary cyclists, without meeting their pharmacological challenge. The case against Armstrong centers around several pieces of evidence:

• An ex-Armstrong masseuse Emma O"Reilly allegedly collected drugs for Armstrong's team, and allegedly disposed of syringes and needles
  
• Armstrong's mechanic saying he spied a box of syringes
• Armstrong's close relationship with the notorious doping doctor form Italy, Dr. Michele Ferrari
  
• and 'first person' testimony from ex-Armstrong friend Frankie Andreu. Andreu over heard an Armstrong confession to his cancer doctor (noted below)
  

Each of these was vigorously contested by Armstrong who is known for mounting a robust legal offense against his accusers including author David Walsh L.A. Confidential ). Armstrong showed little restraint when he spouted off this:

"I just hate the guy," he told writer Daniel Coyle in the 2005 book Lance Armstrong's War, adding that Walsh is a "fucking little troll."

Armstrong seemed to fight the French, especially when L'Equipe leaked results of 'dry run' EPO tests on 1999 Tour de France samples which ostensibly showed Armstrong's test showed EPO. The only Armstrong positive on the Tour was a slight sniff of triamcinolone (a cortisol-like drug), which Armstrong claimed he used for saddle sores. The '99 positive for EPO was never official, which leads to serious questions about the legitimacy of the finding; the second postitive was felt to be a 'theraputic use exemption'.

A notable incident occurred when an insurance company disputing Armstrong's claim unearthed evidence of LA's doing. The major accusers included Armstrong's former friends the Andreus -- Frankie and Betsy. The couple claims that Armstrong told his cancer doctors of his steroids, HGH, and blood doping use while in the hospital. This 'episode' brought huge protests from the Armstrong crowd; the lawsuit was eventually settled outside of court.

Many of Armstrong's teammates and opponents have since admitted to or been nailed with doping over the years:

• Jan Ullrich (presumed blood doping)
  
• Ivan Basso ( intent to blood dope)
• Bjarne Riis ( EPO, growth hormone and cortisone)
• Marco Pantani (EPO, insulin, and cocaine)
• David Millar (EPO)
• Floyd Landis (testosterone)
• Frankie Andreu (EPO)

Armstrong retired in 2006 amid all the suspicions, but without out any of the proof of PED use. He parlayed his fame to noble social causes (cancer awareness) and ignoble social publicity -- he divorced his wife, which led to a number of widely publicized trysts involving notable starlets and singers.

Something burned inside Armstrong, burned to return to the competitive scene. He ran in marathons, finishing respectably. He entered local cycling races. He rode cycling tours for cancer awareness. However, in September word leaked out Armstrong was strongly considering coming back from retirement. He later formally announced his un-retirement, aiming for 5 races including the Tour de France. The comeback plans expanded by the second as Armstrong announced more races and more details. The motivation for the comeback -- enumerated at last week's Clinton Global Initiative -- involved a noble attempt to raise global cancer awareness.

The Armstrong luster tarnished a bit as more details emerged on the LA comeback. Although Armstrong appears to have hired the best anti-doping lab scientist in the United State - Dr. Don Catlin of UCLA -- the last non doped man standing -- Greg LeMond -- challenged Armstrong to expand his claim to 'clean cycling' by including power and oxygen usage parameters in addition to the routine anti-doping urine tests. On another front, scientific controversy swirled around the superiority of the Armstrong physiology.

It was also revealed Armstrong's motives are not quite a pure as the snow atop the Alps -- he invested in a Chicago bicycles parts company that he will apparently promote during the upcoming year. It is also felt that SRAM (the elite cycle components firm) directed Armstrong to Astana, a team that was basically banned from the 2008 Tour de France for doping (Armstrong's former US Post later Discovery has been disbanded, sick of the doping charges). Further, eligibilty troubles may emerge as Armstrong expands his comeback plans.

Lance Armstrong reminds of the ambiguous entrepreneur--win-at-all-costs--sports hero of the past half century. Global icons like Barry Bonds, Roger Clemens, Marion Jones, and Ben Johnson use their sports fame to engage in personal empire building, and at times irresponsible behaviors like doping, cheating, and involvement in illicit activities. Like Brett Favre, Armstrong exhibits that relentless drive to be in the public spotlight that appears to be almost impossible to extinguish in contemporary athletes...although Armstrong's retirement lasted 3 years, not the Favre-ian 3 months. We suspect like Bonds, Clemens, and Jones that beyond the prodigious athletic feats, the other Armstrong non-heroic antics may keep the spotlight acutely focused on him.

The long up and down ride of Lance Armstrong will continue on, perhaps into the next decade(s). And maybe it is as Armstrong says:

When asked point-blank whether he was clean when he won all of his Tours, Armstrong told SI: "Absolutely. I won the Tour de France once, twice, seven times, because I was the most talented person in the field."

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