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PostPosted: Sun Dec 30, 2007 10:01 pm 
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Danton wrote:
I'll summarise / generalise now but synthetic EPO is destined for, say, cancer patients on chemotherapy and studies show it can cause illnesses for them, but the idea is that whilst it can harm you, getting chemotherapy is obviously more beneficial.

The chemo is bad for you, but it kills the cancer. They gave EPO to cancer patients because the chemo supresses red blood cells too. (My wife got it for a while.) I think they've recently stopped giving EPO to cancer patients because of the documented increased long term risks of other cancers.

Danton wrote:
But the interesting thing is that the max doses for EPO in the studies which show harm form what you could call the minimum dose for a doping cyclist. In other words, healthy riders are consuming waaay too much, and their big doses significantly increase the chance of cancer and heart disease.

The truly scary thing I read was that some cyclists on heavy EPO doses had to set their alarms to get up every three or four hours and work out strenuously or else they risked fatal blot clots! :shock:

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PostPosted: Mon Dec 31, 2007 2:45 am 
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swinter wrote:
Danton wrote:
I'll summarise / generalise now but synthetic EPO is destined for, say, cancer patients on chemotherapy and studies show it can cause illnesses for them, but the idea is that whilst it can harm you, getting chemotherapy is obviously more beneficial.

The chemo is bad for you, but it kills the cancer. They gave EPO to cancer patients because the chemo supresses red blood cells too. (My wife got it for a while.) I think they've recently stopped giving EPO to cancer patients because of the documented increased long term risks of other cancers.


As noted above, EPO is *not* chemo, it's to get Haemoglobin back to normal levels in people who are undergoing chemo, or have renal disease.

There are still lots of trials giving EPO to people with a whole range of diseases, I'm not aware of any secondary cancer issues (more likely the result of the chemo or radiation therapy).

The problem is when someone with normal haemoglobin takes EPO to achieve abnormally high levels. It's not the EPO per se that's the problem, just too many red blood cells make the blood too thick and causes blockages.

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Posted: Mon Dec 31, 2007 2:45 am 


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PostPosted: Mon Dec 31, 2007 5:12 am 
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GrahamB wrote:
The problem is when someone with normal haemoglobin takes EPO to achieve abnormally high levels. It's not the EPO per se that's the problem, just too many red blood cells make the blood too thick and causes blockages.

Duh.

GrahamB wrote:
I'm not aware of any secondary cancer issues (more likely the result of the chemo or radiation therapy).

Breast cancer, I think. Goggle it. There was an article about 6 months or so ago.

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PostPosted: Mon Dec 31, 2007 10:12 am 
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GrahamB wrote:
The problem is when someone with normal haemoglobin takes EPO to achieve abnormally high levels. It's not the EPO per se that's the problem, just too many red blood cells make the blood too thick and causes blockages.

I think you'll find studies showing pharmaceutical-EPO use in larger doses increases the chances of other diseases, from bone marrow cancer to heart disease, this was in patients with, for sake of simple language, "thin" blood when chemo or kidney problems brought their haematocrit down to low 30s.

All those riders with their home centrifuges might be trying to avoid blood clots but long term, some will die earlier from ugly illnesses and sadly many probably don't even realise this, no one's told them. This is an issue with doping, that taking large doses of medicines in circumstances for which the products are not destined, is a serious public health issue.


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PostPosted: Mon Dec 31, 2007 3:33 pm 
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swinter wrote:
Breast cancer, I think. Goggle it. There was an article about 6 months or so ago.

Thanks for the tip. Nice article in the New England Journal of Med, here:
http://content.nejm.org/cgi/content/full/356/24/2445

The story seems to be there are risks of cardiac/clot-related deaths when trying to establish normal level in cancer etc patients; also that some tumours (notably of head & neck, squamous cell lung and breast) have receptors that are stimulated to renewed growth by EPO.

There was no mention of EPO causing initiation of cancer in that article.

Basic point stands however: taking this stuff when you're healthy is dumb.

The vexed question: what does training and competing in stage races do for your long term health if you *don't* dope?

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PostPosted: Mon Dec 31, 2007 8:47 pm 
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GrahamB wrote:
The vexed question: what does training and competing in stage races do for your long term health if you *don't* dope?

You're not suggesting that cycling is bad for you, are you?

I would have thought that even the strenuousness of the grand tours is, if you are in shape for it, more beneficial than not. Or are you suggesting that it is just too much stress on the body?

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PostPosted: Mon Dec 31, 2007 8:50 pm 
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EPO has a more potent derivative, Aranesp, which has shown some disturbing side effects, causing it to be pulled.

http://safetywithinpharma.blogspot.com/ ... anesp.html

It does not cause tumors, but it does promote the feeding of oxygen-rich blood to tumors.

EPO is a hormone, and is branded as a red blood cell promoting factor by Amgen, but like any hormone, will have other effects.

It is now well established that EPO has major effects in the brain, not many of which are understood.

My guess is this will lead to tragedies 10 years from now with bizarre diseases appearing in pro cyclists.

However, EPO is also the #1 reason for increased patient survival after chemotherapy, and after blood loss trauma, this drug has saved many lives. It was not tested to be used in longer terms, and in the amounts given to riders.

I agree with Graham, taking EPO while healthy is insane. Morphine helps many deal with acute pain without any side effects, but shoot up all day with the stuff, and you've got major problems.


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PostPosted: Mon Dec 31, 2007 8:56 pm 
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swinter wrote:
I would have thought that even the strenuousness of the grand tours is, if you are in shape for it, more beneficial than not. Or are you suggesting that it is just too much stress on the body?


The average age expectancy of pro riders is below the average population. Many riders of the tour experience immune loss and sickness from diseases they should be easily able to fight off. Lifetime riders experience bone density loss higher than any other sport, and even sedentary people.

Like most things, cycling is a good thing, but in excess it is not.

The TDF and Giro evolved with drugs, they have never been clean, they may not be possible without drugs.


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PostPosted: Wed Jan 02, 2008 1:00 am 
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Interesting.

Guess I have a long way to go, however, before I would have to worry. :wink:

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PostPosted: Wed Jan 02, 2008 10:19 am 
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DocRay wrote:
The TDF and Giro evolved with drugs, they have never been clean, they may not be possible without drugs.

They are possible without drugs. Several riders in today's generation are able to ride clean and even win stages.

No pro is doping out of concern for health, it's for the pressure to win and to earn more.


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PostPosted: Fri Jan 04, 2008 7:08 am 
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"Several riders in today's generation are able to ride clean and even win stages."

Not meaning to be rude, but how could you possibly know this?


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PostPosted: Fri Jan 04, 2008 3:24 pm 
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The same way anyone else could possibly know it not to be true...



The thought that with guys riding don't know the risks is silly. But these are young men we're talking about.

There's not a guy in pro cycling that isn't extremely sure of himself, and though I know people who have doped, I have never known a doper who didn't simply ignore the risk and assume that they're above it. They may still worry, but not enough not to dope.

I also know guys who do not dope. Top flight guys with off the charts ability who simply struggle when they're thrown into the mix at the protour level.

My favorite "comming of age" example is a Pro who was doing early season work with a Big Name team.

He's riding along with a few top guys and their heart rates are all at level X and weight and power output's similar as well, on thier SRM's.

Then 2 weeks later they're overseas and his numbers are a little better and he's happy and they head up a climb and he looks over and the other guys are rolling around 20 beats per minute lower, climbing at the same rate... He said "I felt like punching them in the mouth right there and they knew I was pissed, and they just said "welcome to Europe" ".


All the guessing about EPO aside,

Does cycling need to reconcile?

It can't...

Not for the sake of the sports history nor the sake of the current groupp... It can't fully reconcile and partial is *f##k* meaningless.


But it can change.

Doping needs to be a career ender and needs to penalize the team as well. The UCI didn't have the guts to hold team managers feet to the fire, but the sponsors are pulling the plug and that's having the same effect.


There can be a culture change and cleaner sport, but it will have absolutely nothing to do with some big group hug and honesty...

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PostPosted: Sun Jan 06, 2008 7:25 am 
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PezTech wrote:
Does cycling need to reconcile?

It can't...

Doping needs to be a career ender and needs to penalize the team as well. The UCI didn't have the guts to hold team managers feet to the fire, but the sponsors are pulling the plug and that's having the same effect.

There can be a culture change and cleaner sport, but it will have absolutely nothing to do with some big group hug and honesty...

No one's suggesting a group hug. (I don't think they did that in South Africa either.) The point of "truth and reconciliation" is coming clean and being accepted back into the community. Like David Millar. An amnesty program that allowed riders to ride if they came clean would do more to pressure the team managers (and sponsors) than any other single tactic.

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PostPosted: Mon Jan 07, 2008 1:28 am 
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PezTech wrote:
My favorite "comming of age" example is a Pro who was doing early season work with a Big Name team.

He's riding along with a few top guys and their heart rates are all at level X and weight and power output's similar as well, on thier SRM's.

Then 2 weeks later they're overseas and his numbers are a little better and he's happy and they head up a climb and he looks over and the other guys are rolling around 20 beats per minute lower, climbing at the same rate... He said "I felt like punching them in the mouth right there and they knew I was pissed, and they just said "welcome to Europe" ".


Can you comment about the prevalence of doping in US domestic teams? Not just smaller drugs ala Nathan O'Neill, but testosterone/EPO/whatever. I've known and ridden with a few pros and many cat1s. A few suspect but are not sure (mostly the cat1 who are demolished in races), and others are "absolutely sure" of it -- including one (former) pro who was quite successful.

Not just Europe, but how about the smaller American teams?


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PostPosted: Tue Jan 08, 2008 6:13 pm 
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swinter wrote:
PezTech wrote:
Does cycling need to reconcile?

It can't...

Doping needs to be a career ender and needs to penalize the team as well. The UCI didn't have the guts to hold team managers feet to the fire, but the sponsors are pulling the plug and that's having the same effect.

There can be a culture change and cleaner sport, but it will have absolutely nothing to do with some big group hug and honesty...


No one's suggesting a group hug. (I don't think they did that in South Africa either.) The point of "truth and reconciliation" is coming clean and being accepted back into the community. Like David Millar. An amnesty program that allowed riders to ride if they came clean would do more to pressure the team managers (and sponsors) than any other single tactic.



David Millar didn't come clean. David Millar was caught cheating.


Not bagging on Dave as his efforts have been admirable, but there's a huge difference between getting busted and simply falling on your own sword and it's the legal hassles and potential negatives that make this impossible.

David simply had a whole lot less to lose, just like Riis, Zabel and others who simply admited to things that they couldn't be punished for...


Expecting that riders throwing themselves to the wolves will make managers any less cut-throat is an interesting assumtion, but it will absolutely never happen.

I would say that money being made less available will have the biggest impact. Short of the UCI doing anything to bring more accountability to team managers, it's the sponsors pulling their dollars that is having the impact right now.


The UCI simply do not want to hold team managers accountable because the UCI frankly are in jeopardy of loosing their place as governing cycling. They don't want to threaten the guys keeping them in power and the guys keeping them in power don't want to loose the stanglehold on riders and the money...

If a hundred riders stepped up and said "yes we doped", I hold the opinion that not much would change after the media storm subsided.


Cycling is changing a bit now because the money is drying up. Teams are accountable and managers own money is now in play, so teams are now trying to have a closer look at their riders...

But I would venture that teams have always had an excellent view of what their riders were doing... The difference needed to be that teams should have been looking to keep riders clean rather than simply testable.

If they know they can suffer directly because they passively support doping, they will try and prevent it. Before it was simply a matter of being able to throw a rider under the buss and walking away, but the sponsors have spoken to some degree to make some of the "stink" stick to teams after they've tried to shovel the sh!t away...

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