Lance Armstrong, (currently) four time Tour de France cycling champion, is a survivor of metastatic testicular cancer. This book is largely the story of how his life changed from the moment of his diagnosis (October 2, 1996) onwards. He had been a world class cyclist prior to cancer, but his experience with cancer gave him profound insight not only into his life as a cyclist and competitor, but into life itself.

It is this latter insight which he recognizes as ultimately the most important aspect of his cancer experience. Armstrong notes: "Odd as it sounds, I would rather have the title of cancer survivor than winner of the Tour, because of what it has done for me as a human being, a man, a husband, a son, and a father." (p. 259)

Written in a conversational, straightforward tone, the book chronicles Armstrong's childhood in Texas as the son of a strong, loving, supportive, financially struggling, young mother; his beatings at the hands of a step-father; and his early excellence at endurance athletics. Armstrong became a brash powerhouse cyclist and began to enjoy the material rewards of winning while ignoring the onset of symptoms. At the time of diagnosis, the cancer had spread to his abdomen, lungs and brain.

He documents his search for optimal care, sperm banking, lack of health insurance, surgeries, chemotherapy, self-education and interactions with doctors and nurses. Through it all he acknowledges the tremendous support of his mother and friends, as well as sponsors who stuck with him with no assurance that he would survive, let alone race.

Before he was even through the first year, he decided to start a charitable organization, The Lance Armstrong Foundation, dedicated to cancer research and support of cancer survivors. Through this effort he met his future wife, Kristin Richard (Kik), and her love and support helped him through the dark days of emotional soul-searching post-treatment. The book also details her struggles with successful in vitro fertilization (They currently have a son and twin daughters).

Chapter Nine, The Tour, is an in depth look at the 1999 Tour de France which Armstrong won with the help of his US Postal Service teammates, expert coaching, and his will. This race is brutal, dangerous, and as Armstrong notes, both "a contest of purposeless suffering" and "the most gallant athletic endeavor in the world." (p. 215) He details the maneuvering in the peloton, the strategies, the stages and personalities.

The book concludes with reflections on the birth of his son, the anniversary of his cancer diagnosis, the love of his wife, and his need to ride.


I don't know what I expected after reading this book, but I know I didn't expect to be crying while putting my daughter to bed. Yet that is precisely what happened, because this story hit me at a very human level. The term "inspirational" is far too sappy for this gutsy memoir, known as "The Book" by many a cancer survivor. I smiled at the part where Armstrong curses at a nurse who encourages him to use the incentive spirometer post-operatively--because I would love it if a patient ever defiantly shot the ball up to the top on my post-op visits.

There are terrific moments in the book, both highs and lows, but what I admire most is Armstrong's refusal to equate remission with attitude. He acknowledges that even with the best of care and the most positive let's-beat-this stance, people die of cancer.

There are two pieces to consider for comparison if using this memoir in a classroom setting: Raymond Carver's poem, 0023 [see this database] for reaction to seeing one's chest X-ray film covered with metastases; Nancy Keene's "He Lifted His Eyes," for reaction to removal of the chemotherapy catheter (Journal of the American Medical Association, 277: 1502, 1997).

The reason I read the book is not because of Armstrong's latest feat--triumphant though that is, nor any prior interest in cycling, nor the fact that the book has been a best-seller. The Lance Armstrong Foundation very graciously supported a Compassion in Medicine award at Stanford University School of Medicine this year, and it was this generosity that tweaked my interest in the man behind the philanthropy. After reading his story, I feel even more honored that the LAF chose to support this award and a renewed sense of gratitude for the privilege of being a physician.


Sally Jenkins, an accomplished sports writer, is the collaborator for this book.


Penguin Putnam

Place Published

New York



Page Count