http://d3epuodzu3wuis.cloudfront.net/C150.pdf

ALLEGED “CONFESSION” OF LANCE ARMSTRONG’S EPO USAGE PRIOR TO
CANCER TREATMENT

12. I did not have any knowledge of the background of Lance Armstrong before October 19,
1996. I have been told that it is alleged that Lance Armstrong admitted to his doctors, in front of other non medical personnel, that he had used performance-enhancing drugs prior to being
diagnosed with cancer. I have no recollection of being present during any conversation where
Lance Armstrong stated this. Though I was not Lance Armstrong’s sole physician, I was
responsible for the majority of his treatment and would have been present at every large meeting
where discussions took place or decisions were made. I have, as mentioned above, had the
opportunity to review Lance Armstrong’s medical file and can confirm that no entry has been
made, neither by me, nor, by any other doctor that saw Lance Armstrong, to the effect that Lance
Armstrong had been taking performance-enhancing drugs. I have never seen any evidence, either
from myself or any other doctor, that indicates Lance Armstrong admitted, suggested or
indicated that he has ever taken performance-enhancing drugs. His medical file from Indiana
University Medial Center shows that during his treatment at the Center he was asked questions
regarding his medical history over 20 times, which included questions regarding his past medical history and past medications and drugs taken. Nothing in the chart indicates he ever said or responded that he had taken performance-enhancing drugs. The anesthesia and surgical preoperative notes from October 23, 1996, the day before his brain surgery, are particularly
instructive. In that situation, the anesthesiologist and the doctor are visiting with the patient in a very serious situation where accuracy in responses is very important. These doctors disclosed the risks of the brain surgery and anesthesia to Lance, including damage to adjacent tissue, and nuerological decline such as weakness, numbness, speech and vision problems and they discussed his medical history. Had there been any indication from Armstrong to either of these physicians that he had used performance enhancing drugs, that response would be noted in his records. There is no such note. I and other medical personnel visited with Armstrong about his
medical history before his chemotherapy started on October 28, 1996. Lance Armstrong never
admitted, suggested or indicated that he has ever taken performance-enhancing drugs. Had this
been disclosed to me, I would have recorded it, or been aware of it, as a pertinent aspect of Lance Armstrong’s past medical history as I always do, for example, for prior smoking history, alcohol use, illicit drug use and HIV risk factors for each and every patient. Had I been present at any such ‘confession,’ I would most certainly have vividly recalled the fact. As stated previously, I did not know Lance Armstrong personally or professionally at the time of the first encounter, therefore, there should be no suggestion that I may have somehow purposely omitted to record or recall Lance Armstrong’s confession. In any event, I would have recorded such a confession as a matter of form, as indeed, would have my colleagues. None was recorded.

13. Though doctors are under a professional obligation to record all matters regarding a
patient’s medical history in his/her notes, it would be unusual to ask a professional athlete who
has been diagnosed with testicular cancer whether or not he had previously used performanceenhancing
drugs. I have treated other athletes with testicular cancer and don’t recall ever asking
them whether or not they have used performing-enhancing drugs.

14. While on this point, I believe that it is important to respond to allegations that perhaps
the use of performance-enhancing drugs such as EPO can cause cancer and indeed may even
have caused cancer in Lance Armstrong. There is no established scientific evidence that EPO can
cause testicular cancer. From my treatment of Lance Armstrong I am confident that his cancer
could not have, and indeed was not, caused by the use of performance-enhancing drugs.

Was the doctor telling the truth? Were the other people? If so, who made up that story, and why?

Lance Armstrong had no comment to Oprah Winfrey about this.

Your proof is that he survived?! I thought you said it had a 40% survival rate.

That was one of the claims. And it wasn’t 40%, but “less than” 40% And that did not include everything discovered.

The condition as fully described seems to have had less according to estimates in various reports.

I think it’s most probable he took EPO more than officially prescribed, and certain specific vitamins like Vitamin A, and one other thing had to be there to get his immune system to target the cancer, and I don’t know what it would be. I should try to look up clinical trials – maybe only on mice – at that hospital or by those doctors – at that time.

And either all of the people who testified to hearing him admit drug use OR his doctor, or both were lying around 2005, and Lance Armstrong even now feels it’s too sensitive a subject.

Let’s say his doctor is lying – we’re half way there to proof something was different about his treatment. Especially if it was said but was kept out of the medical records.

Lance Armstrong: “I’m not going to take that on. Laying down on that one. …I’m gonna put that down.”

Lance Armstrong admitted doping to Oprah Winfrey, claimed everybody did it so it was a level playing field, claimed he never pushed anyone to do that, and said how could the USADA say he ran the most sophisticated doping program in sports history – what about the East Germans in the 1970s?

I suppose the USADA could say that was massive, but it wasn’t as sophisticated. They never had to beat the kind of tests Lance Armstrong did.

Only the fact that he got better, when, according to the description he gave, he should have had very poor chances and he has given no explanation as to what he did different (beyond using somewhat different chemotherapy drugs)

Your proof is that he survived?! I thought you said it had a 40% survival rate. Let’s assume that it was only 25%. 1 out of 4 would be expected to survive, yet you would suggest that the 1 out of 4 cheated and/or broke the law.

Do you have any evidence of this, or is this one of those things that because you think it is somehow possible, it becomes plausible?

Is it safe to assume it is the latter?

In Pursuit of Doped Excellence – New York Times Magazine, January 18, 2004

Currently, in determining whether to put something on its banned list, W.A.D.A. considers whether a substance is performance enhancing, contrary to the spirit of sport or potentially dangerous to health. ”If it meets two of the three criteria, we are likely to put it on the list,” Pound says.

But the first two criteria are ambiguous. Steroids and EPO are clearly performance enhancing. But so might Gatorade be, if you believe its advertising and all the data on the ”science of hydration” disseminated by the Gatorade Sports Science Institute. And plenty of sports drinks claim to do more than Gatorade. ”You identify a line and draw it somewhere,” Pound says. ”Why is it the 100-meter dash and not the 97-meter dash? It just is.”

Between Gatorade and anabolic steroids lie all those powders and pills and injectibles that elite athletes put into their bodies, in quantities and combinations that may enhance performance or may prove innocuous. In most cases, no one is quite sure.

Less open to interpretation is ”potentially dangerous to health.” Any medical or pseudo-medical activity that takes place underground or in the black market is, by definition, dangerous. Nearly everyone, regardless of how they feel about abortion, will agree that it’s more dangerous when it occurs in a back alley. Steroid use, dicey in most situations, is certainly more so when it takes place in the dark.

So issues of health are the strongest rationale for W.A.D.A. and the whole antidoping effort: to protect athletes from their own worst instincts.

Comment by JD (b63a52) — 1/17/2013 @ 4:15 pm

Do you have any evidence of this, or is this one of those things that because you think it is somehow possible, it becomes plausible?

Only the fact that he got better, when, according to the description he gave, he should have had very poor chances and he has given no explanation as to what he did different (beyond using somewhat different chemotherapy drugs)

I was reading through the comments to a New York Times article about Lance Armstrong from last October, and I discovered something interesting:

Erythropoietin (or EPO) the drug that Lance Armstrong is supposed to have used after his cancer treatment (he later switched to blood transfusions of his own blood) is also used, and used to be used more, in cancer treatment! There are now all kinds of warnings about it. It’s supposed to give people heart attacks because it supposedly thickens the blood, and it is supposed to promote cancer. EPO was never used to treat cancer – it was used to counteract the anemia caused by chemotherapy, because the number of red blood cells got too low. EPO stimulates the growth of blood cells.

But, wait! Certain immune cells grow in the same place. What if a doctor had a theory, and was right, that EPO could boost the immune system.

Like for instance, here:

http://www.pnas.org/content/98/9/5181.full.pdf

Now at that time there’s already a campaign against using EPO because it is supposed to harm people. It doesn’t build up till about 2002. But here we already sime worry by 1990 about heart attacks:

http://articles.latimes.com/1990-06-02/sports/sp-143_1_performance-enhancing-drug

And articles from 2008 indicates someone was climing caner already by 1990.

Any doctor would get in trouble for using it as a treatment against the cancer itself. Lance Armstrong might possibly arrange for a bootleg supply. Which later on he would use for racing.

By 2007, the EPA adds a black box warning:

ttp://www.nytimes.com/2007/03/10/washington/10fda.html That has to do with heart attacks.

Now maybe that’s only risky if the red blood cell levels get way too high, well above anything seen naturally. This page says levels up to 48% are OK.

http://www.hammernutrition.com/knowledge/diet-for-increasing-your-natural-epo.280.html

They continue to worry about tumors:

http://www.nytimes.com/2008/03/12/business/12anemia.html?pagewanted=print

Now it’s supposed to cause cancer or make it worse:

http://ki.se/ki/jsp/polopoly.jsp?l=en&d=130&a=133831&newsdep=130

In any case, Lance Armstrong would have gotten EPO during cancer treatment, and there’s testimony that he did get it.

Here’s the doctor he gave EPO to Lance Armstrong in 1996 till about Jan 1997, and that he tested him later, periodically till 2011 – twice a year after about 1998 – and would have recognized something odd about his hemotocrit levels.

Dr, Craig Nichols also states that he was not present, but probably should have been present if it happened, when Lance Armstrong supposedly admitted to doctors using performance enhancing drugs (and that should have been recorded on medical records too if he admitted it too)

d3epuodzu3wuis.cloudfront.net/C150.pdf

Here is a 2006 discussion forum where this is mentioned, also the claim (apparently in 2005 testimony) that he had told doctors that he had previously used it. Somebody is lying.

http://www.bikeforums.net/showthread.php/205544-Lance-admits-EPO-use-NOT-DURING-CANCER-TREATMENT

Here is what looks like a mid-2000-2010 decade view of EPO as a palliative during chemotherapy:

http://www.rndsystems.com/cb_detail_objectname_SP04_Erythropoietin.aspx