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Still cancer after all these years

In 1988 Lance Armstrong was a cocky, healthy, teenage triathlete. We called him Junior back then, and cancer was the better part of a decade away from changing his life for worse and, eventually, for better. Cancer did find him, and yellow rubber bracelets are worn by those in and out of sport, triathletes inclusive. But neither the Lance Armstrong foundation nor the purple-jerseyed TnTers who fatten multisport's starting lines formed the first intersection between triathlon and cancer.

That distinction belongs to the Pioneer Team, founded by Scott Zagarino back in that summer of 1988, when Lance was Junior, half-Ironman races were a rarity, and duathlons were called biathlons. Ironically, it was "Zag" who introduced me to "Junior," the brassy kid who would eventually swim for awhile the wetsuits and ride the bikes I made in my San Diego factory. But that’s another story.

Zag's Pioneer team wasn’t a fundraising vehicle. It was a grouping of many of the world's best athletes whose good work consisted of visiting terminally ill children. Many of the 13 to 16 year old kids with whom the team members formed relationships were AIDS patients who contracted the disease through blood transfusions. Many were cancer sufferers.

It was tough duty for these pro athletes (at right), which included Colleen Cannon, the Puntous twins, Brad Kearns and Andrew MacNaughton, Ray Browning, and George Hoover. The team grew to 75 pro and age-group athletes in Kelowna, British Columbia, as well as in Boulder and in Los Angeles. They visited weekly, on a one-on-one basis. These triathletes grew to know about 1000 kids throughout the 4-year life of the team.

These patients were terminally ill, and none survived. Not one. It might've seemed a bad fit, the alpha narcissists in the "me" sport of the "me" decade engaged in what might be the hardest something-other-than "me" duty there is. "Triathlon gets a bad rap," says Zag, “because of a biopsy of our sport that gets put under the microscope. It's the self-absorbed that want the attention, that get the bumper stickers and tatoos, that say 'look at me,' so we look and it's no mystery what we see. But if you took 1000 triathletes and compared them to 1000 people who walk into a McDonalds, triathlon is an impressive demographic; not just in income, but in empathy and compassion."

Zag's intersections with triathlon are many and various. Where most failed he succeeded in putting together what might have been the most effective pro union, IFET, which introduced the first drug-testing protocol and equal prize money across the sexes, both more or less uninterrupted and in effect today (Zag is at left, Pioneer Team coach and drug protocol architect Mark Sisson at right at Zag's "biathlon" in Anaheim in 1992).

After a decade-and-a-half in absentia, Zag is back, and he's bringing cancer with him. It's prostate cancer, a kind a lot of triathletes can relate to. Interestingly, the force behind the funding used for much of the prostate cancer research is Michael Milken, one of life's retreads with whom Zag can perhaps emotionally caucus. Though neither a survivor of prostate cancer or of Wall Street — both of which Milken is — Zag can maybe relate. His four years running the Pioneer Team, at the pointy end of cancer’s grief, as well as a crushing divorce a decade ago, have made him more reflective. In keeping with the cliche, Zag emulated the many hard chargers-turned-Zen Buddhists and you'll now find him reflective and self-deprecating, though not syrupy or Stepfordish. His tastes run more toward non-competitive athletic pursuits, and we've written about his camps that emphasize teamwork and comeraderie.

The point is, Milken's power and intellect has been focused by two decades of unremitting fires of various kinds, and that seems analogous to what's happened to Zag. Indeed, it is only the simple accident some billions of dollars that separate them. Zag now finds himself on Milken’s team, that is, Zag is leveraging the sport of his adult life against a disease that many male triathletes will have to face.

Prostate cancer is the male analog to breast cancer in certain ways. Both deal with sex organs, and with one's vanity and sense of worth. Neither cancer is as likely to kill you as to give rise to other, much deadlier, cancers. They both share a certain indiscriminate unfairness about them: A healthy multisport lifestyle likely won’t protect you.

According to Zag, there is one thing these two cancers do not share, and that is the typical response by those who are diagnosed. "While breast cancer is extremely personal," he says, "women have come out of the closest. Women get news of their breast cancer on Friday, they go into the office on Monday morning and announce it.

"With men, it's not that way," Zag explains. "A man comes back from the doctor, he knows there is a significant chance of a bad complication like impotence, or incontinence. Who's he gonna call with that news?"

Zagarino was attracted to Milken's pragmatic, businesslike approach to prostate cancer. "He was emotionally and personally incentivized to find the most pragmatic solutions. What were the problems? Let's say you’re a brilliant doctoral candidate, what you really need is 10 years of funding. But prostate cancer's low on the sexy scale of cancers. So he says, 'To solve this, we need to entice these great minds to work on prostate cancer.' And he puts up $25 million seed money to make it happen."

So you're that brilliant doctor. "You apply," says Zagarino of the Prostate Cancer Foundation, "we review in 30 days, we fund in 60."

But this comes at a cost. You can't sit on your discoveries. You have to share with others vested in the research. "When NIH funds you, you are not compelled to share your research," maintains Zagarino. "With the Prostate Cancer Foundation, you have to share, you have to open your books annually."

How likely will we, as triathletes, be to contract prostate cancer? In a way, more likely than others, should our healthy lifestyles grant us extra years of life. As of now, 1 in 6 men will be diagnosed. It's worse for black men, for whom the odds are 1 in 3.

The older you get, your risk skyrockets. It's 1 in 10,000 for men under the age of 40, then 1 in 40 men who are in their 40s and 50s, and when you're over 60 you've got 1 chance in 14.

What are prostate cancer's symptoms? There are few. The insidious thing about prostate cancer is that it's likely you don't know when you have it, absent a PSA test (prostate-specific antigen test).

The test itself is controversial, because of the high rate of false positives. Better identification of the disease is one of the areas of study that the Prostate Cancer Foundation is invested. Other studies receiving funding explore gene therapy to selectively eliminte prostate cancer cells; the stopping cancer's growth factors, and the development of blood vessels that feed cancer cells; and several other potentially fruitful endeavors.

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