Tuesday, August 12, 2008

Cancer and the Olympic Games

Just like other people, athletes can get cancer, too.

Everyone knows about Lance Armstrong’s amazing feats after beating testicular cancer. Most hockey fans remember Mario Lemieux returning from treatment for Hodgkin’s Disease to lead the Pittsburgh Penguins to the Conference Finals. Baseball fans from my home town (Baltimore) probably remember Eric Davis being treated for colon cancer while playing for the Orioles.

This year’s Olympic Games has a similar story. On June 19, one week before he was scheduled to leave for the US Olympic trials in Nebraska, Eric Shanteau was diagnosed with testicular cancer. His doctor cleared him to go to the trials anyway.

Shanteau wasn’t given much of a chance to make the team, but when Brendan Hansen faded on the last lap, Shanteau passed him, came in second, and secured a spot on the team. That’s when he had to face the difficult decision of whether to go to Beijing and compete, or get his cancer treated without delay.

His primary oncologist recommended immediate treatment, even though that would have kept him from going to the Olympics. Shanteau sought out other opinions, and decided to have weekly blood tests and go to the games.

Controversial as his decision was, his teammates rallied behind him and been inspired by his courage. "It's been quite inspiring in many ways," backstroke world record holder Aaron Peirsol said at a team press conference last week. "The way he's handled this, you step back and realize there's more to all this than just swimming."

As an oncologist, I have mixed feelings about this decision.

On the one hand, Shanteau is an adult and can make his own decisions, prioritizing his Olympic dreams above all else. Elite athletes make decisions like that all the time. And he’s lucky, because testicular cancer is something that can be followed easily with blood tests. A rise in the blood test would indicate the disease is progressing, and Shanteau has said if that happens he’ll go back home and start his treatment. Also, his ability to compete in such a high pressure environment while he has cancer is incredibly inspirational, especially to people who might otherwise think life ends when cancer begins.

On the other hand, the oncologist in me worries that this young man may be prioritizing his career over his health. Then again, if caught early, testicular cancer is very curable. In fact, the cure rate for localized disease is over 90%. The cure rate is good for widely metastatic disease too, but his chances of survival are not nearly as good if his disease spreads before he begins treatment. Is Shanteau sacrificing his chance at long term survival just for a swim meet?

He’s an adult. He can decide where his priorities lie. And regardless of whether this was a good decision, Eric Shanteau’s story remains an inspiration to us all.


Anonymous said...

It is amazing that Eric can compete with the elite swimmers of the world with testicular cancer. I will be rooting for him and hope he do well with his treatments in his future.

jaime said...

Personally, I'm with you on this one....if he were my child, or brother, or husband, I would urge him to get treatment first. This is his life we're talking about.

Joy Logan said...

I know a male who I am sure has testicular problems...how do I get him to get help???

Anonymous said...

The truth is that an extra month or so not treating what has been reported to be a low stage tumor, especially when it's testicular cancer, probably isn't a big deal - especially since it can be watched with tumor markers. I would certainly make the same decision, and I would support anyone I knew personally who did the same. It's the olympics for god's sakes! Forget about putting a career before health, this is a life time dream and experience, vs a likely very small chance that his tumor burden will dramatically change.