August 28, 2002 | When cyclist Lance Armstrong crossed the finish line in Paris to win his fourth consecutive Tour de France, among the well-wishers cheering along the Champs-Elysées was Dr. Craig Nichols, the Portland oncologist whom Armstrong credits with saving his life. "We went out with Lance afterwards and drank beer," Nichols says with a smile. "It was great fun."

Nichols, 50, first met Armstrong in 1996 at the Indiana University Cancer Center, while the cyclist was fighting testicular cancer, Nichols' specialty. "He was a fairly cocky, brash young man," Nichols recalls, "but he was starting to realize the severity of his situation. He was, as you might imagine, very willful and very determined."

Nichols credits Armstrong's assertiveness, in part, for saving his life. Although testicular cancer is among the most treatable forms of cancer, by the time Armstrong first met Nichols, it had quickly spread to the cyclist's abdomen, brain and lungs.

Already a well-known cyclist, he experienced his first symptoms in 1996 when he was only 25. Plagued with fatigue, he'd had a disappointing year of racing. During the off-season in October of that year, he coughed up blood one morning. Soon after, one testicle became so painfully swollen he couldn't sit on his bike seat. A doctor friend told him to get immediate attention. After he was diagnosed as having testicular cancer that had reached his lungs, doctors soon found that the cancer had spread to his brain. That's when he found Nichols.

"He was very aggressive about seeking out expert care very early -- which clearly made a difference," Nichols says. By working with a doctor who specialized in testicular cancer, Armstrong was able to tailor his chemotherapy to minimize any damage to his lungs, increasing the chances he would be able to preserve his cycling career.

In his book written with Sally Jenkins, It's Not About the Bike: My Journey Back to Life, Armstrong, all swagger and bluster on the outside, admits, "it was humbling to be so scared. More than that, it was humanizing."

Nichols says the cyclist did the right thing by seeking out the proper expertise, something many are hesitant to do. "I think it's inherent in most people's nature to accept your doctor's opinion without question, and that's a mentality that I would like people to get [away from] a little bit," he says. "I think a second opinion is always a good thing to ask for, particularly with very serious illnesses. But people are afraid that they're going to make their physician angry."

Now Medical Director of Lymphoma and Testicular Cancer Research at the Providence Cancer Center in Portland, Oregon -- his hometown -- Nichols says he always wanted to be a physician. "He was four-years-old, and he said, 'I'm going to grow up and be a doctor,'" his mother, Phyllis, recently told the Portland Oregonian. "He just knew, and he never deviated."

With graying blond hair, Nichols appears fit but fatigued, like a lot of hardworking physicians. He walks nearly four miles to work every morning and jogs home, yet he'd probably confess to needing a bit more sleep.

Despite Armstrong's fame, his doctor ignores the media attention he's attracted and keeps a relatively low profile. Aside from a couple of photos in his office showing the doctor with his famous patient, you'd never know that outside the hospital he was anything but a father of two teenage boys. He doesn't even like to ride a bike.

Taking on 250 new patients a year, Nichols is known throughout the medical community for his warm manner with patients, a reputation he humbly shrugs off. "I think it's important that you be true to your own personality," he says.

"If you are engaged with your patients and feel like you are a partner with them in trying to get through this, it's relatively easy to talk to them about both good and bad things," Nichols says. "Even if they ultimately die of their disease, you can take pride in the fact that you helped them manage their symptoms as well as possible," he says.

Nichols recalls that while he was at Indiana University, he treated a 25-year-old Mennonite woman who had contracted a very aggressive form of cancer. "It was absolutely untreatable, and there was clearly nothing to do," he recalls. "She was very short of breath from her lungs being full of cancer, and she couldn't leave the hospital, but we made her as comfortable as we could. [One] morning I walked into the room and her entire family and most of the community had come up. There were probably at least 30 people singing hymns to her."

Despite having a daily front-row seat to the ravages of cancer, "I've never felt it's depressing," Nichols says. "You get to see the whole range of family and personal dynamics, and human will and courage and spirit, great outpourings of love and anger. You get inspired on a daily basis. Lance is obviously a spectacular example, but there are bus drivers and schoolteachers and college students that struggle every bit as hard and harder."

For those, like Armstrong, who do survive the disease, Nichols preaches what he calls the "obligation of the cured."

Nichols encourages patients to give whatever they can, be it advocacy, volunteer work, or if possible, charitable support. Taking Nichols' advice, Armstrong has done "all of the above," in his doctor's words, through the Lance Armstrong Foundation, for which Nichols designed the scientific arm.

"Anyone cured in the year 2002 has a great debt to the patients that have gone before him," Nichols says. "I believe if you're given such a great gift in terms of being returned to health from such a dreaded disease, you need to remember that and make sure that in some ways you serve future generations with the same sort of illnesses."

-- Brian Libby is a freelance writer who has contributed stories to Salon.com, the New York Times, Willamette Week, and other publications.

Last updated July 28, 2009
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