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Lance Armstrong's book, It's Not About the Bike: My Journey Back to Life, tells the very personal story of his battle against testicular cancer. A critique of major themes identified in the narrative provides an opportunity to inform nursing practice.
©2009 Society of Urologic Nurses and Associates Urologic Nursing, pp. 415-421, 443.
Key Words: Testicular cancer, control, supportive relationships, meaning, survivorship, masculine health behaviors.
Testicular cancer is a relatively rare disease that strikes primarily between the ages of 15 and 35 (Brown, 2004). Approximately half of the men diagnosed already have disease progression due to a delay in seeking medical attention and the tendency for testicular tumors to grow extremely rapidly (Mason & Strauss, 2004a; Rosella, 1994). Advanced disease has been correlated with decreased 5-year survival figures (Brown, 2004; Mason & Strauss, 2004b). Despite this, around 70% of men with metastatic testicular cancer will achieve complete remission as a result of modern day treatments (Rudberg, Carlsson, Nilsson, & Wikblad, 2002; van Basten et al., 1997).
Lance Armstrong is an accomplished American cyclist, widely known as a seven-time winner of the Tour De France. At age 25, he was confronted with a fast-growing form of testicular cancer that had already spread to his lungs and brain. This presentation necessitated aggressive treatment with orchidectomy, surgical excision of metastatic brain lesions, and cisplatin based chemotherapy. Even with that treatment regimen, his chances of cure were seen as less than 5%. Armstrong's book (Armstrong & Jenkins, 2000) tells the very personal story of his battle against testicular cancer and his subsequent journey of self discovery. It takes the reader from the discovery of symptoms that he initially ignored, through the shocking moment of diagnosis with advanced disease, onto the surgeries and endless days of chemotherapy, to his period of survivorship and his eventual triumph over the disease.
The narrative of Armstrong's cancer journey provides the reader with valuable insights into his perception of his experience. The rich fabric of his story reveals many themes ripe for consideration by health professionals and lay people alike. This article utilizes current literature to critique five major themes drawn from Armstrong's description of his experiences of testicular cancer. The themes are masculine health behaviors, maintaining control, supportive relationships, making meaning, and survivorship....