Lance Armstrong and doping – what, if anything, is left to say?

http://lancearmstrong.com/news-events/lance-armstongs-statement-of-august-23-2012

So now I am finally free to write about Lance Armstrong with little chance of initiating a lawsuit, I find rather little of interest to say. Everyone had pretty much made their minds up one way or another anyway and I think the story had already been factored into people’s views about the Tour de France and doping. I suppose as a scientist a few things stand out that are still unresolved. Let’s assume that if Lance was doping – which I am sure he will deny to his grave – then he beat a lot of people who were also doping. Was he better at doping (possible)? In some strange way was his testicular cancer and its benefit in a real biochemical/physiological way (possible I guess, but the mechanism would be strange)? Or was he just head and shoulders above every one else in his talent, training and preparation that in anything close to a level playing field he would emerge victorious (I guess the most probable answer)?

As a scientist, I don’t think I can comment too much on the US Anti Doping (USADA) agency evidence. The case is after all predicated primarily on detective work and witness statements, not scientific analysis of blood or urine samples. We don’t have the fine details yet although USDA do say they will reveal it in due course; I really hope they publish it all for the good of the sport, including naming all their sources. I personally would like to know what was the basis for the following statement “Additionally, scientific data showed Mr. Armstrong’s use of blood manipulation including EPO or blood transfusions during Mr. Armstrong’s comeback to cycling in the 2009 Tour de France”. Clearly these cannot have been direct EPO tests or he would have been banned at the time. Nor can they have been homologous blood transfusions (also detectable). They must be a version of the athlete hematological passport (which was later introduced by cycling). But on their own they cannot have been definitive it seems to me or more would have been made of them at the time.

So what now? I think my concern is less of what this means for Armstrong but more about the relationship between UCI (cycling’s governing body) and the world’s anti doping agencies. UCI tried to stop the USADA case and it is not clear that they will agree to Armstrong’s Tour de France titles being expunged. In return USADA pretty much accused UCI of corruption  - see http://online.wsj.com/article/AP65c10ede4cfb4303a1870a3d1c18200a.html. It will be a shame if, just as cycling appears to be heading for a “cleaner” phase, some of the momentum is lost with this squabbling. 

Talking to the media about doping at the Olympics

Largely because of the furor about the Chinese swimmer, Ye Shewin, I have spent a lot of time in TV and radio studios recently. My book, Run, Swim, Throw, Cheat is really about the science of doping now and what could happen in the future. But of course I get asked a lot of more general questions as well. I thought I would indicate the most common queries and my usual response:

1            What drugs do athletes use and do they work?

I usually answer this with the unholy trinity: anabolic steroids for power events like sprinting, blood doping for endurance events and amphetamines (or similar) to prevent fatigue. If pressed I say that the strongest evidence for benefit is using blood doping (whether transfusions or EPO injections) and anabolic steroids, especially in female athletes.

2            How many athletes dope?

Always a tricky one: I first state the number that test positive (0.5 – 1%). Although this could be an overestimation, as testers target the more suspicious athletes, I think it is more likely to be an underestimation. I usually settle on somewhere between 1 and 10% have tried doping in their career at any time. Nice and vague. Of course this number varies dramatically between sport and country. But I do think it is not a majority and we need to recognize that.

3            Who is winning the war on doping?

I always say this is impossible to answer - how would we know if the dopers were using an undetectable compound? But it is likely the dopers and testers are on top at different times. Given the identity of all elite athletes is known – and their number is relatively small compared to all criminals in the world – if enough money and police intelligence was thrown at the problem it would make it very hard for the dopers to succeed routinely. But maybe this money is better spent on building a new hospital or improving our schools instead?

4            Are athletes gene doping?

Although theoretically possible, like most scientists I think it very unlikely this is successfully being used at present. There are likely more effective, and cheaper, ways to cheat anyway.

5            Why not stop spending all this money in an unwinnable anti doping war and let athletes do whatever they want to succeed?

I answer this, by saying, that we should be careful what we wish for. The best example is anabolic steroid use in female athletes. Unrestricted use led to the health problems we say in East German athletes. We may not like the look of the competition we create. If we allow steroid use under controlled medical supervision we may have healthier competition for those obeying the rules. But there will still be a few who want to go further. How can we check this without an effective anti doping regime? The same system needs to be in place, just working with a different set of goalposts.  

5            Why not have an Olympics competition for “normal” athletes and another for those using whatever they can to be the best that they can be?

This is an easy answer. Some of the methods tried in the “doping” games would involve illegal drugs. Many of the athletes would live shortened lives in the pursuit of victory. Which competition do you think Coca Cola or McDonalds would sponsor? Which would the BBC or US networks cover. This kind of question is philosophically valid to ask, but practically a waste of time to think about. It ain’t going to happen.

I will be talking about this, and more, including my demonstration of blood doping using red wine, at the Edinburgh International Book Festival on August 27 (http://www.edbookfest.co.uk/the-festival/whats-on/chris-cooper).

Is there excessive doping at the London 2012 Olympics?

I am writing this blog near the end of the Olympics – but as I go on holiday in a few days I thought I would take the risk of summarizing my view of what has happened so far. The events started with a well-orchestrated bang as the International Association of Athletics Federations announced the banning of nine track and field athletes on the eve of the games. Three were caught when samples were re-tested from last year’s world championships. Six were banned based on the “athlete biological passport”.

Both the number of athletes and the nature of the tests were significant. The London anti doping laboratory will keep the athletes’ urine and blood samples taken Olympics for eight years. At any time in the future they can be re-tested. This has been done before; in fact there has been some controversy over how little was done with the Athens samples collected at the 2004 Olympics, the statute of limitations for testing of which is about to run out. However, recently some re-tests were ordered and amongst those caught were the Belarusian hammer thrower Ivan Tsikhan. In the case of London, I suspect the World Anti Doping agency will be much more aggressive.  They have collected more samples than ever before and – uniquely – have stored the data in a way designed to capture the molecular fingerprint of as many unknown drugs as possible. I think it is now very risky to use a previously undetectable or unknown drug at the games itself; all potential medalists will be tested and eight years is a long time to keep a secret. We have seen before with the US BALCO scandal when a disgruntled coach sent a syringe of the undetectable steroid to the US anti doping agency, there is little honour amongst thieves.

However, testing at the games is only one part of an effective anti doping strategy. Out of competition testing, both random and targeted at suspicious athletes, is key to catch athletes who can get benefits from drugs even if they stop taking well before the games themselves. A new innovation is the athlete biological passport. This aims to take regular snapshots of an athlete’s metabolism via urine and blood samples to see whether there are any suspicious changes that might indicate doping are occurring. In principle an athlete can be banned via this indirect “smoking gun” even if no actual banned drug is found in their body. At present this is limited to detecting blood doping, but it is hoped to extend it to hormonal markers that might include human growth hormone and anabolic steroids. Bans have indeed been implemented in cycling and track and field athletics. I believe that combining aggressive use of the passport in a small cohort of registered elite athletes with holding all samples and data for eight years would make it prohibitively difficult to cheat by doping. But the cost of such a program would make it impossible to implement in all Olympic sports.

So what has happened at this year’s games? As many have said before it is rare to catch someone at the games itself (why dope when you are almost certain to be tested?). So there has been the usual procession of “dopy” dopers i.e. people who are just bad at cheating or cheat by mistake. One athlete fell foul of the same steroid, stanozolol, that Ben Johnson was caught using in his infamous 1988 100m race. Perhaps the doper hadn’t read his history? Another ate a brownie before he left for the games that he claimed someone had laced with marijuana. Thanks mate!

But the real controversy has been about commentators (including those on the BBC) and some coaches (step forward John Leonard) implying people had been doping simply due to posting a fast time. For reasons I have discussed elsewhere this approach is fraught with danger. In the case of the Chinese swimmer, Ye Shewin, there is a really nice statistical discussion on the BBC web page that shows her time, whilst outstanding, is not so unusual that it should trigger accusations of doping (http://www.bbc.co.uk/news/magazine-19116749)

I will be talking about this, and more (including my demonstration of blood doping using red wine) when I discuss my book Run, Swim, Throw, Cheat at the Edinburgh International Book Festival on August 27 (http://www.edbookfest.co.uk/the-festival/whats-on/chris-cooper).