If Diagnosed Today, How Would America’s Most Famous Cancer Survivor Fare?


The following is from Dr. Craig Nichols, Co-Director of the Testicular Cancer Program at Virginia Mason Medical Center, member of the LIVESTRONG Board of Directors and Lance Armstrong’s oncologist.

It was 1996. A relatively unknown 25 year-old Lance Armstrong sat across from me in my office at Indiana University. He was struggling with the news that he had advanced, widely disseminated cancer in his abdomen, lungs and brain. At that moment, he was seeing a bright line being drawn across his life, dividing the “before cancer” portion full of energy and optimism versus the “after cancer” portion with looming disability, infertility, pain and quite possibly death.
My team and I developed a course of treatment for Lance that applied standard, readily-available medications and practices to achieve cure and high-quality survivorship. It’s the same course of treatment used for patients today. After brain surgery and rigorous chemotherapy, Lance recovered. He started a small foundation focused on fellow survivors, one that eventually grew into a global advocacy movement and national service provider for people affected by cancer. Then Lance took up his cycling career again and won an unprecedented seven Tour de France titles, becoming an inspiration to millions who embraced his triumphs with hope for their own battles against the disease.

Fast forward to the present. I’m often asked whether we gave Lance some sort of mythical special treatment or molecular wizardry reserved for celebrities and politicians. The answer is no. His recovery was due to tried-and-true treatments and medications like Cisplatin, a drug developed in the mid-1960s.Today, Cisplatin remains the cornerstone of cure for testicular cancer and is highly effective against many other malignancies. And this life-saving drug is on the Food and Drug Administration’s drug shortage list. Of the three manufacturers who produce Cisplatin, one has ceased production, a second has manufacturing challenges and the third can’t keep up with demand by itself.

Were Lance diagnosed today, the odds would be stacked against him.

For cancer and many other treatable diseases, effective and often inexpensive generic drugs are becoming scarce in the United States. More than 180 commonly-used drugs for anesthesia, infectious disease, arthritis and cancer are in desperately short supply. Americans are being forced to delay critical treatments or take substitutes, often suffering unnecessary pain and side effects.

The causes of this drug shortage crisis are many and complex. According to recent congressional testimony by the U.S. Department of Health and Human Services, three quarters of these shortages involve older, sterile injectable drugs. These are typically inexpensive drugs with low profit margins. Half of these sterile injectable drug shortages are due to product quality issues such as particulates and impurities. One fifth are due to production delays and capacity issues, and 11 percent are due to manufacturer discontinuations, usually for business reasons.

It is clear that market factors are playing a significant role in this problem, including industry consolidation and shortages of raw materials. While the Food and Drug Administration (FDA) does not have the authority to force drug companies to manufacture drugs in short supply, the agency is responsible for patient safety and must ensure that regulatory barriers within the drug approval process are not overly burdensome. In addition, Congress must ensure that the FDA has the necessary resources to address these problems and that the incentives are aligned properly to encourage manufacture.

Regardless of the causes, as a result of the shortage, physicians are forced to prioritize who gets life-saving treatment. Is it the young man with testicular cancer or the mother of three with ovarian cancer? Words can’t explain how terrible those decisions are or how frustrating it is to see this country regressing in its ability to provide access to high quality care.

And sadly, there are those all-too willing to exploit patients, insurers and states and offer drugs at 10 to 20 times the normal rate. To date, this price gouging remains perfectly legal.

Federal and state governments, professional societies and patient advocates are scrambling to address these unexpected challenges. Senator Amy Klobuchar and Representative Diana DeGette have introduced legislation that calls for manufacturers to give the Food and Drug Administration six months’ notice before ceasing production on a prescription drug. It is a good first step. However, swift and urgent action is required by the federal government and by the pharmaceutical industry to provide for people in need of treatment today. End the price gouging now. Build solutions that assure Americans have access to the treatment and medications they need and deserve. And put measures in place that prevent this crisis from every happening again. Every day that this problem remains unsolved, we lose lives and cause unnecessary suffering.


The drug shortage crisis requires immediate action by the federal government and the pharmaceutical industry. LIVESTRONG will work to ensure that patients’ voices are represented during the search for solutions. We will also keep our spotlight trained on this issue and take every opportunity to remind manufacturers, elected officials and policy makers that failure to act is not an option. Americans expect and deserve solutions now.


  1. shirley Ledford says:

    For the past 20 years I’ve watched as Wall Street applauded M&A’s (mergers and acquisitions). They are too short sighted to see the problems they created. Excellent smaller companies were absorbed by larger companies who used them to boost company profits and CEO’s bonuses. No thought was given to the “greater good” these companies provided the market. “Regulations” will have to be made and enforced to correct the imbalance in the market place so it works for the general public, not just shareholders and CEO’s. The FDA needs modernized and adequately funded to provide the necessary oversight.

  2. Larry Nelson says:

    The main problem is the new health care bill. I am a molecular biologist and after that bill was passed, most research into new drugs stopped. I have a friend that works for a major drug company and they basically stopped all r$d. One thing that seems to be lost on the actual cost of drugs is the regulation. It currently costs over 100million to get a drug to market. Second is that most drugs today have their cost subsidized by ED meds. What the Health Care bill did was remove patent times, and move drugs to generic. This removes the ability of the companies to produce the drugs and sell them at a price that allows them to keep producing and researching new drugs.

  3. Jerzy Wieczorek says:

    No có? w Polsce chemioterapia dzieli sie na standardowa i niestandardowa. Przy czym o podaniu chemii niestandardowej nie decyduja lekarze lecz urzednicy.

  4. Scott Joy says:

    How can we best help?

    1. We should have a call to action next week. Stay tuned. We’ll need to hear from those affected by the shortages. Thank you for your unwavering support!

  5. Darcy McGee says:

    Wall Street isn’t short sighted: it’s motivated by profit, and profit only.

    A cured cancer patient represents a loss of revenue to a company.

    Good healthcare is not measured in profits. It’s measured in living.

  6. Matt Ellefson says:

    This is just plain unacceptable. Please let me know how I can help.

    don’t just live…..LIVESTRONG!

  7. Megan Zopf says:

    This concerns me. My son was diagnosed with Testicular cancer one year after Lance Armstrong. Sean was in a study in Boston Mass and I believe Dr. Nichols was the founder of that study. I do know Cisplatin was one of the chemo drugs used in that study. Sean, like Lance, is alive and doing well. I know there have been some issues recently getting drugs and I pray this problem can be taken care of ASAP. It was bad enough us having to wait for BCBS of PA to approve this study. I can’t imagine anyone in this country having to put their life on hold because of the lack of drugs needed to go forth with their treatment. This problem needs to be fixed immediately!
    Megan Zopf

    1. Megan- Thanks so much for commenting. LIVESTRONG needs your help and that of your son. We will be collecting stories this week of those affected by the drug shortage. If you know of anyone that is facing the crisis, please tell them to contact us. We will have a survey available to fill out in a matter of days. Stay tuned.

  8. Bill Blank says:

    This is a sad commentary on our society when profit motive and CEO bonuses trump need. We have been looking for a cure to cancer as long as I remember. We are told about breakthroughs but not about the cost and supply issue of the drugs that will bring this about. I keep praying that we will overcome the stumbling blocks to not only finding the cure but we will make it happen because we can. I speak as one who lost his wife to cancer.

  9. Kumben says:

    Shocking and very scary

  10. Lindyjo Geo says:

    I have stage 4 lung cancer. Last week I was told by my oncologist that Cisplatin was unavailable to finish the remaining 9 treatments left in my scheduled treatment plan. I had finised the first 3 Cisplation combo treatments and was ready for chemo #4. Shock turned into hopeless depression and that turned into my ongoing search this week to locate another medical facility who has Cisplatin or Etoposide suppy on hand. Please wish me luck in my search. Something HAS to be done to fix this problem. It is OUTRAGEOUS and is only happening in our grand and glorious United States of America. :(

    1. LIVESTRONG says:

      Please take the survey when you can. We hope to bring the voice of the patient to the table and help shape solutions. Visit http://www.surveymonkey.org/drugshortage to take the survey today!

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