This book, a sequel to It's Not About the Bike: My Journey Back to Life, chronicles five-time Tour de France winner Lance Armstrong's personal and professional triumphs and agonies from late 1999 (after he won his first Tour and after the birth of his son Luke) to mid-2003, the 100th anniversary of the Tour. Armstrong defines himself by his cancer experience and survival; he devotes himself to both one-on-one connections with fellow cancer patients as well as his public persona to raise awareness and funds for cancer programs and survivors' needs.

There are many medically related themes in the book. Descriptions of cycling sports injuries and illnesses include a severe concussion, a broken cervical vertebra, dehydration, road rash, tendonitis and exhaustion. Armstrong experiences the loss of friends and acquaintances to cancer and trauma. He is the subject of an intense investigation into the possible use of recombinant erythropoietin and finally cleared of suspicion after nearly two years. As a world class athlete, he is subject to frequent, random drug testing.

His wife experiences a failed in vitro fertilization cycle, though a subsequent successful treatment leads to the birth of healthy twin girls. The Red Cross invites Armstrong to visit NYC firefighters soon after the devastation of September 11, 2001 in a successful effort to boost morale. Armstrong, though, describes encounters with some cancer patients in which he felt he did not succeed in providing the desired inspiration.

Despite reaching his five-year cancer-free milestone, Armstrong, like many other cancer survivors, wonders if the cancer will return. He is hyper-vigilant of his body not only because of his elite athlete status, but also because of his cancer history. Nonetheless, he is reckless and jumps from a steep cliff to sense the rush of fear and freedom.

Armstrong trusts and believes in modern medicine and technology, as well as the physicians, nurses and other health care practitioners dedicated to cancer treatments and health care. He also lauds complementary practices, particularly the team chiropractor who uses a variety of techniques to support the riders during the grueling Tour.