Lance Armstrong: A Soul For The World

Lance Armstrong is a truly amazing person.


He is a world class athlete. He is a cancer survivor under perhaps the most difficult of circumstances.  He is someone who didn’t sit back on his successes and memories but instead reached out and created a focus on cancer and survivorship that has touched millions.


Today, the Lance Armstrong Foundation announced that they were taking the cancer fight globally, as an integral part of Mr. Armstrong’s decision to reenter competitive cycling.


Wearing his suit and his sports gear, he has committed to working throughout the world to bring attention to cancer, and the plight of those who suffer from cancer—frequently silently and in pain—in Africa, Australia, or wherever his journeys may take him.


We tend to forget that fighting cancer is a worldwide effort. Not just in the developed world, but throughout the emerging economies as well.  The cancer world is becoming increasingly flat.


After we get done patting ourselves on the back about the significant advances we have made in cancer research and treatment, we should take a moment to remember that it wasn’t so long ago that our relationship with cancer was much, much different than it is today.  It was, in fact, similar to what we see in less developed parts of the globe today.


A couple of years ago, a colleague of mine travelled to Tsibili, Georgia (the one near Russia, not the Georgia I live in).  While there, she gave several talks and visited with cancer specialists and patients.  She gave us a detailed description of her experiences when she returned to our home office in Atlanta.


The report was pretty much what one would expect: the Georgians had limited medical facilities, they had limited availability for screening mammography, a lot of people smoked, and there was little attention to pain control and end of life care for patients with cancer.


Hearing this discussion, I raised my hand and offered some observations:


When I started my oncology practice in Baltimore in 1977, we didn’t have much in the way of mammography.  We didn’t have organized chemotherapy units in many hospitals and we certainly didn’t have sophisticated outpatient chemotherapy services with trained staff. 


We had a lot of people who smoked at work, in restaurants, or wherever people gathered.  We didn’t pay much attention to pain control, and hospice—or any other form of end-of-life care—wasn’t available in any organized fashion. 


We didn’t have chemotherapy nurses, and we had little we could offer to offset the serious and disabling side effects of cancer treatments.


But there was something else we didn’t have, and that was open and honest discussions between doctors, patients and families about cancer. 


There was a huge stigma surrounding the diagnosis of cancer. Families literally demanded that their loved ones not be told they had cancer, even if they were going to receive radiation therapy and/or chemotherapy. 


I can’t tell you how many times doctors told me early in my practice that I could not tell their patient their diagnosis, or discuss their treatment.  If I didn’t comply with their wishes, I wouldn’t get any more referrals.


That was the state of cancer treatment in this country in the 1960s and 1970s.  Patients weren’t fooled, families couldn’t say goodbye, and everyone played a game of charades.


Today we are much further along in this country when it comes to cancer diagnosis, treatment and cancer care, although we still have a long road to travel.


What I saw here in the United States 30 years ago is not unlike what exists in many places in our world today. 


If we were able to make such progress with the cancer experience over the past three decades, then one can only imagine the progress we could make elsewhere if we carried a message of hope and help for those in need. 


Granted, many of these countries have far fewer resources.  But that doesn’t mean you don’t start making the effort.


During his comments at today’s press conference, Dr. John Seffrin (who is the Chief Executive Officer of the American Cancer Society, and someone who has been exceptionally committed to the global fight against cancer for many years) alluded to the battles we have fought here—such as smoking and tobacco—that we now have to take to the world.


There is a slide from one of Dr. Seffrin’s talks that I regularly use in my lectures.  It shows the epidemic pattern of cigarette smoking in the United States, beginning in the early 1900’s, followed by the inexorable rise in lung cancer deaths a couple of decades later. 


As Dr. Seffrin has noted, we are now responsible for spreading that epidemic globally.  What Philip Morris couldn’t do here any longer they now are prepared to do to millions of people wherever they live around the globe.


Fighting the influence of tobacco companies worldwide, providing adequate pain relief for patients with cancer, treating infections which cause cancer, using vaccines to prevent cancer, getting screening mammography into countries around the globe, assuring funding for cancer research in those countries like Australia which have well developed cancer research programs—these are all on the table as we look to what we can offer the world in reducing the burden and suffering from cancer.


My hat is off to Lance Armstrong and his colleagues at the Lance Armstrong Foundation for their commitment, their dedication and their hearts being in absolutely the right place.


When organizations work together to a common cause, there is no limit to what we can accomplish. 


The American Cancer Society has committed its name and its resources to taking the cancer fight globally.  It is not alone.  


The Lance Armstrong Foundation, New York Mayor Michael Bloomberg, The Gates Foundation and the Clinton Global Initiative are proud examples of what we can accomplish when we make commitments not just with money, but with soul.


Lance Armstrong has soul.  He is travelling a path of commitment to a cause that is greater than any one person.


I don’t know what the future holds for Mr. Armstrong and his team when it comes to his cycling career, but for many he is a winner for all time.

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