The Hindu Business Line : Life and trial by EPO

AS he battles allegations of doping, Lance Armstrong — and those who read his autobiography — must be reflecting on the strange relationship he has had with erythropoeitin (EPO). A protein hormone, it is core to the controversy now surrounding the cyclist; but, in 1996-97, the blood booster had helped in facing intensive chemotherapy after Armstrong was diagnosed with testicular cancer.

According to information on the Internet, EPO is a glycoprotein hormone that is a growth factor for erythrocyte (red blood cell) precursors in the bone marrow. It increases the number of red blood cells and is mostly produced in the human renal cortex; production stimulated by low oxygen levels in interstitial cells of the peritubular capillaries of the kidneys.

"Administered erythropoeitin produces the same effect as a transfusion of red blood cells, but can be given chronically without risks of repeated transfusions.

"It is most often given to people with anaemia associated chronic renal failure, but can be beneficial in many types of anaemia due to diseases that interfere with RBC production, such as that due to chemotherapy. Epogen and Procrit are two US brands; at least one has been advertised on television as a treatment for tiredness in cancer patients,'' the Web site nationmaster.com said.

In some sports, particularly cycling and long distance running, EPO has been used as a doping drug because higher amounts of red blood cells can increase the oxygen carrying capacity of the blood and improve endurance.

"In cycling, EPO is most useful for multiple-stage races because it avoids the ordinary effects of increased tiredness on athletes,'' the Web site said.

But high usage and resultant thickening of blood can cause severe adverse effects, ranging from nose bleeding to heart attack.

In the book, Its not about the bike - my journey back to life, written by Armstrong and Sally Jenkins, it is mentioned that the cyclist was given EPO to combat myelo-suppression, "the most frequent and severe side effect of chemotherapy, which is the inhibition of red blood cell production and maturation."

Armstrong wrote, "Chemo weakens your blood. During the third cycle, my hematocrit - percentage of total blood volume flowing through my body - fell to less than 25, and the normal count is 46.

"Ironically, I was given a red blood cell booster called Epogen (EPO). In any other situation, taking EPO would get me into trouble with the International Cycling Union and the International Olympic Committee, because it's considered performance-enhancing. But in my case, the EPO was hardly that. It was the only thing that kept me alive."

EPO use became a scandal in the 1998 Tour de France, which Armstrong - still on his comeback trail from cancer - did not take part in. But he noted in the book, "In a series of raids on team cars, French police found trunk loads of EPO and anabolic steroids.

"Team members and officials were thrown in French jails, everyone was under suspicion, and the cyclists were furious at the tactics used by authorities. Of the 21 teams that began the race, only 14 finished. One team was expelled and the other six quit in protest.

"Doping is an unfortunate fact of life in cycling, or any other endurance sport for that matter. Inevitably, some teams and riders feel its like nuclear weapons - that they have to do it to stay competitive within the peloton. I never felt that way, and certainly after chemo the idea of putting anything foreign in my body was especially repulsive.

"Overall, I had extremely mixed feelings about the 1998 Tour: I sympathized with the riders caught in the firestorm, some of whom I knew well, but I also felt the Tour would be a more fair event from then on.''

The allegations of doping against Armstrong, which appeared earlier this week, relates to the 1999 Tour de France, the first time he won the race.

This week, the French sporting daily L'Equipe had reported that the cyclist's use of EPO was revealed in tests by a French laboratory of his frozen urine samples from the 1999 Tour.

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Life and trial by EPO