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Photograph by Glenn Kasin

Can Livestrong Survive Lance Armstrong and a Doping Scandal?

The world's most famous cancer survivor has been his foundation's biggest asset, even as it grew into an innovative force in health care. Now his legal troubles may make him a risk.

On a Sunday night in late July, a trio of bouncers stand outside a chic club near the Champs-Élysées, in Paris, checking guests for a special bracelet with a black plastic charm of a No. 28 cycling jersey. Inside, a red and white logo-festooned racing bike is on display like a sculpture. The absence of a rider is appropriate: This is the post-race celebration for Lance Armstrong's last Tour de France.

He's just finished a humbling 23rd in a race he's won seven times. But the mood at the Team RadioShack party is upbeat. Longtime Hollywood producer Frank Marshall is there. So is surfing superstar Rob Machado. CNN's Sanjay Gupta. Twitter investor and entrepreneur Chris Sacca. Executives from Google and Sony. A U.S. ambassador. The Champagne flows.

In the midst of the VIPs, working the room furiously, is Doug Ulman, the 33-year-old president and CEO of the Lance Armstrong Foundation, better known as Livestrong. It was Livestrong that was the real winner at the Tour. Nike had lined the course with Livestrong banners and covered it with supporters' messages in bright yellow paint ("Lost my leg but not my courage"). Yellow rubber bracelets were everywhere. A controversial stunt that morning, in which Armstrong and his RadioShack teammates broke Tour rules by donning black jerseys to honor the 28 million people worldwide living with cancer, had become big news on the biggest day of the Tour.

"Where's Lance?" guests shout to Ulman over Michael Jackson's "Billie Jean."

Armstrong arrives around 11. Dressed in an elegant dark suit and white shirt, he's the last rider to take the small stage and address the crowd. All those years when the leader's yellow jersey was his personal uniform, he mostly avoided crashes. Not this time: "It all caught up to us this year," he says, perspiring under the lights. But he smiles, takes a few photos with the team, and talks about what the Tour did for his cancer campaign. "I wanted to take the Livestrong message around the world," he says. "You could not have brought more attention to the issue today."

Then he disappears into a curtained-off area. "I was thinking, I can't wait to get out of here," he tells me later. He was headed to the Bahamas on vacation with his family.

What no one at the party mentions is the legal shadow lingering over Armstrong. Since May, federal investigators have been exploring whether he used performance-enhancing drugs while winning his Tour titles. He proclaims his innocence, as he has in the past. But the special agent in hot pursuit is the man who put Olympian Marion Jones behind bars and made a name for himself by exposing baseball's steroids scandal.

Unlike the cases involving Barry Bonds or Roger Clemens, there's more at stake here than one athlete's reputation. Armstrong is not only "the most famous cancer survivor in the world," in the words of John Seffrin, CEO of the American Cancer Society. He is also the inspirational figure behind the most entrepreneurial foundation in cancer, a critically important health-care movement that helped win $3 billion in new funds for cancer research and prevention in Texas alone.

While its $50.4 million in annual revenue is less than what the 97-year-old American Cancer Society raises in a month, Livestrong has been a catalyst for better cancer care and education across the globe. "It's a force to be reckoned with," says Leslie Lenkowsky, a professor at Indiana University's Center on Philanthropy. Livestrong's help line, guidebooks, and website helped more than 400,000 people last year. Its social-media efforts reach about 3 million supporters. It has pioneered programs here and abroad for survivors; worked to unify the fractured cancer community; and instigated a worldwide crusade, which includes the United Nations and the Clinton Global Initiative, to make the world's No. 1 killer a health-care priority. "I can't think of an organization with the breadth of activity that the foundation has," says Dr. Larry Shulman, chief medical officer at the renowned Dana-Farber Cancer Institute in Boston, "and that includes the American Cancer Society."

Which puts Armstrong, and CEO Ulman, in an uncomfortable position. The two are "soul brothers," as one Livestrong sponsor puts it: both cancer survivors, both highly competitive and disciplined athletes, both bright, passionate, and charismatic activists. "If we want to talk about cancer or go out and have beers at happy hour, that's fine with me," Armstrong says. Together they have built something remarkable. Armstrong attracts attention and supporters; Ulman melds them into a powerful community.

Even if Armstrong isn't ultimately charged, a prolonged investigation that sullies the foundation's public face could take a toll on its fund-raising and, most important, its credibility. Will corporate sponsors and donors differentiate between the founder and his foundation? While Ulman awaits the outcome, he's being forced to wrestle with a critical question about his boss: Is Livestrong's greatest asset also its greatest risk?

Ulman sees the investigation as a cycling scandal that pales in importance compared to fighting the world's deadliest disease. But that's not to say Armstrong's legal trouble doesn't enter into his thinking. "It's made me more focused," Ulman says. "Twenty-eight million people are counting on us."

★★★★★

Brian Singer is one of the 28 million. He's 32 but looks ancient, his face swollen from chemo, his head hairless. He sits hunched in a wheelchair at the Hospital of the University of Pennsylvania. "I feel beat down," he says. "Destroyed." But he's determined to stay awake to meet a man who had the same disease — testicular cancer that spread to the lungs and brain — and survived.

It's late August and Armstrong is in Philadelphia for the annual Livestrong Challenge — one of four around the country — equal parts rally, fund-raiser, and race. Armstrong is squeezing in a hospital visit, as he does about once a month. He's already donned gown and gloves to visit with two patients in isolation. When he enters the conference room where Singer waits with several other cancer patients in wheelchairs, he is trailed by a gaggle of doctors, administrators, and a hospital camera crew.

"Ready to get out?" he quips. Armstrong has a knowing, almost mischievous grin that only a fellow member of the cancer club could pull off. He steps carefully over IV lines and sits down next to an older man who lost his forearm to cancer and whose chemo-ravaged voice is barely audible. At one point, Armstrong introduces a Livestrong employee — "She's one of us!" — a breast-cancer survivor.

Singer, an ex-Marine, doesn't tell Armstrong that one tumor was too deep in his brain for surgeons to remove when they cut out others. Doctors gave Singer a 10% chance of survival back in April. He doesn't describe how he got laid off from his IT job and the stress on his wife, Kimberly. He simply asks, "How do I get my energy and drive back? All I want to do is sleep."

"If you want to sleep, sleep," Armstrong tells him. "When I was in the hospital, I slept 20 hours a day."

This is the Lance Armstrong the public doesn't see. Lance Armstrong, cancer coach. "I have to be judicious about [cancer patients] I tell him about," says Jonathan Thomas, president and CEO of American Century Investments, a Livestrong partner. "The last time I saw Lance, he remembered a colleague of mine whose daughter has pancreatic cancer. He asked, 'How is she? You got her number?' He called her cell right then."

Through its help line and other services, Livestrong also acts as a cancer coach, one that extends beyond the reach of its founder. Armstrong's stay at the Philadelphia hospital is brief, but the organization remains, in a program for survivors created and funded by Livestrong.

The cynics and Armstrong haters — and there are many — characterize his involvement with Livestrong as a predictable image-burnishing campaign by a troubled celebrity. It's a convenient but flawed narrative. He started the organization 13 years ago, before winning the Tour de France, before dating singer Sheryl Crow made him tabloid fodder, before many outside pro-cycling ranks knew who he was. Dr. Craig Nichols, the Portland, Oregon, oncologist whom Armstrong says saved his life, described "the obligation of the cured." Armstrong took it to heart.

Armstrong is not giving interviews these days, but after his hospital visit he makes an exception to talk about his foundation. The one stipulation from his lawyers: The investigation is off-limits. As we get started in a hotel suite north of Philadelphia, he moves my recorder closer, to the arm of his chair. In street clothes — dark jeans, a white shirt, and khaki canvas boots — he looks wiry, almost slight.

"I don't like people," Armstrong tells me.

"Seriously?"

He chuckles. "I'm not saying, 'I don't like people!' " he repeats with fake hostility. "But if I have the chance to hang out by myself or with my family or a very small group of friends, I will take that every time."

Ulman, he says, is the guy who thrives in an environment like the Paris party — a fellow survivor who has the intellect, tenacity, and people skills to tackle the complexity of cancer on a daily basis. "I'm not a Rhodes Scholar, but I can figure out real quick who is," Armstrong says. He trusts Ulman to run Livestrong, just as he trusted Johan Bruyneel, who coached Armstrong to a record seven Tour wins. "He's my Johan."

Before the trickle of news stories about the doping investigation, Armstrong's retirement from professional racing was the most urgent concern for Livestrong. He's been an unusually active chairman, talking with Ulman most mornings, even during the last two Tours, and exchanging daily emails. As he races less, Armstrong tells me, "I'll be spending more time in the office, as much as I can. But certainly not sitting at a desk on a daily basis. I've never done that."

But he knows that ending his cycling career could diminish the organization's exposure. "You expect some falloff [in fund-raising and media exposure], but we're not seeing it," he says. "We'll see in the next year or two." As early as 2004, he and the staff at the Lance Armstrong Foundation were strategizing about how to rely less on its founder and his fame. Then Livestrong, with its yellow wristbands, evolved from an online community where survivors share their stories into a full-fledged brand about cancer, not just Armstrong's cancer. Unofficially, the foundation has changed its name. "We found ourselves slipping and calling it Livestrong," says Armstrong, who says he'd wanted a different name all along. "It was just a little much to see your name on the door, the letterhead, the website." A surprising comment from a man who demanded the cycling spotlight.

At a dinner that night for Livestrong fund-raisers, he doesn't give a speech. Instead, he shares the stage with longtime buddy John "College" Korioth, who ran the foundation early on and acts as tonight's emcee. Armstrong gives serious six- and seven-minute answers to Korioth's questions about a disease that kills nearly 600,000 people a year in the U.S. and the impact banning smoking would have. Regarding his six years on a presidential cancer panel, Armstrong says, "If I had a dollar for every time somebody mentioned tobacco control, I'd be a rich man, and this disease would be almost gone."

"You kind of are a rich man, dude," Korioth cracks.

Later, Armstrong jokes about a cancer-free world in which the Livestrong headquarters becomes a "big-ass bar" and tells the sort of stories you don't hear at cancer conferences. Like the time he and Korioth were playing golf. Armstrong couldn't find his tee shot: "I said, 'College, did you take my ball?' And College says, 'No, man, cancer did.' True story."

The Livestrong crowd roars.

"In the sports world, he's a very polarizing figure," says Ulman. "In cancer, he's not."

★★★★★

I first met Doug Ulman in the summer of 1997, when I wrote about him in Brown University's alumni magazine. We sat in his parents' kitchen in Columbia, Maryland, outside Baltimore, and he told me how he had survived cancer the previous year. He was 20, a junior on the university's soccer team.

One night during a run with his older brother, he'd felt his throat tighten up. Doctors found a malignant tumor called chondrosarcoma and removed six inches of his rib. The surgery was so successful that Ulman avoided chemo, but several months later, when he thought he was in the clear, he was diagnosed with melanoma. Twice. In less than 12 months, he'd had three scares with two kinds of cancer. "You think you're indestructible," he told me. "Then you're in a hospital bed signing consent forms that say the side effects of your treatment are dizziness, nausea, and death."

Ulman did more than return to play soccer at Brown. He started a foundation to help young cancer patients. Children and the elderly had resources; people his age didn't. I was struck by how impassioned and preternaturally poised he was.

After the story ran, he got an email from a 26-year-old cancer survivor in Texas. He'd started a foundation that year too: "Being a young man in the prime of your life both athletically and physically, then to be struck by cancer is devastating... . But I feel as if we are the lucky ones. Nobody can really have the perspective and the focus of a cancer survivor."

Lance Armstrong and Ulman — the lucky ones, the pro cyclist and the college student — became email buddies. Over the next few years, Armstrong began collecting Tour de France championships, and Ulman got a grant to run the Ulman Fund full-time. The young men finally met in 2000 at a Lance Armstrong Foundation bike ride, but they didn't hang out until that fall, when they had dinner in San Francisco. They talked for five hours. More people were surviving cancer, they agreed, yet no one was addressing their needs. Ulman was only 23, but it was obvious that he knew his stuff. Armstrong persuaded him to become one of four staff members at the foundation.

"It was the opportunity of a lifetime," Ulman says. "The board said, 'We'll take care of resources. You think about how to help people.' "

The group had begun by modeling itself after the Susan G. Komen foundation for breast cancer, raising awareness and research funding for testicular cancer. Instead of a Race for the Cure, Armstrong's team conducted a Ride for the Roses. But he and the board, which included longtime Austin venture capitalist Jeff Garvey and former Dell president Lee Walker, yearned to have greater impact — a reflection of its founder's personality. "We've always said we have to pound on the door and maybe kick it in," says Korioth. "If people get their feelings hurt, tough crap. People are dying. We're not going to wait around."

After Ulman arrived, the team focused on what happened to people after treatment. He developed and ran the "survivorship" program, teaming up with the Centers for Disease Control and Prevention and the National Cancer Institute to study survivors' needs, and awarding grants to eight cancer centers to set up programs dealing with issues such as fear of relapse and the side effects of chemo. "We know the fight never ends," reads the Livestrong manifesto. "Cancer may leave your body, but it never leaves your life."

There was no field of survivorship until Livestrong created it, says Dana-Farber's Shulman. "As oncologists, we were entirely focused on making the cancer go away. We weren't looking at people's long-term problems." He adds, "It's hard for me to think of another organization that has done things like this, so seriously, in an academic and scientific way. Not to mention something started by an athlete."

From the time Ulman joined the foundation, he has been Armstrong's main contact. When Ulman, just 29, was named president and CEO in 2007, Armstrong recalls that "there were people who said, 'God, this kid's so young. How can he run this multimillion-dollar organization?' I just said, 'He probably could have run it from day one.' "

Ulman is particularly skilled at turning Armstrong's friends, VIP admirers, and corporate sponsors into assets for Livestrong. It was Ulman, for example, who answered Bill Clinton's question — "What's going on in cancer now?" — when the former president offered the Livestrong pair a lift to New York on a private jet. Ulman described "the gap between what we know and what we do." Many cancer deaths are preventable; effective treatments aren't reaching people in time if at all. Clinton responded by outlining his strategy in raising awareness and global funding for HIV and AIDS, through the UN, particularly in the developing world.

That conversation led to the international launch of Livestrong at the Clinton Global Initiative, in 2008. "People in the U.S. don't think of cancer as a global problem," says Claire Neal, Livestrong's senior director of mission. In fact, 60% of cancer deaths occur in developing countries, which receive only 5% of cancer resources. The daughter of a pediatric oncologist, Neal headed a team that spent 18 months interviewing survivors overseas and gathering data. She found that people who think cancer isn't treatable don't get diagnosed early enough for treatment to work. Often, people who are diagnosed are ostracized, or they keep their disease a secret, adding to their isolation. Neal's work led Livestrong to mount anti-stigma campaigns in Mexico and South Africa with local NGOs.

Meanwhile, Ulman was following Clinton's approach to UN funding. He and Livestrong chief of staff Morgan Binswanger, a 20-year veteran of not-for-profits, worked with the U.S. State Department and the World Health Organization to push for a special UN session that would encourage countries to increase cancer spending. As they point out repeatedly, the disease claims nearly 8 million victims a year, more than AIDS, malaria, and tuberculosis combined.

Last year, Livestrong held its first global summit in Ireland, modeled after the Clinton Global Initiative; some 300 policy makers and cancer leaders from 65 countries committed to increase funding for care and research. In terms of diversity and clout, says Seffrin, the head of the American Cancer Society, "the summit was unlike any heretofore." The partnerships that grew out of the summit played a part in the UN's announcement in May of its first summit on noncommunicable diseases — cancer is the largest — in the fall of 2011.

"Our goal is to have a transformational impact on the disease," says Ulman, "not to simply make incremental changes."

★★★★★

"People know who we are, but they don't know what we do." Ulman is sitting at his cubicle in the middle of Livestrong headquarters, a renovated warehouse just east of downtown Austin. In the open-air lounge, he and his colleagues have just watched the U.S. soccer team's stunning World Cup win in the final minutes against Algeria. Ulman, who is Armstrong-lean from running several miles every day before work, was the only one here predicting a comeback when the Americans had one cleat on the plane home. "I'm an optimist," he says.

Ulman doesn't dwell on the obstacles of fighting cancer. How the disease has been around for so long that it lacks the urgency of a natural disaster like the earthquake in Haiti. How cancer isn't one disease; it's more than 100, each with its own universe of patients, specialists, researchers, and not-for-profits, and its own biologic puzzle. How turf battles undermine efforts to combat cancer with a capital C and make it a national or global health-care priority. Instead, Ulman focuses on empowering patients and survivors by providing information and creating a community.

At any one time, part of his 82-person staff may be working with the American Cancer Society to produce a report on the global economic impact of cancer — $895 billion annually, according to the August report — while others are directing community grants of several thousand dollars to support innovations that could work nationally. But at the heart of Livestrong is a dedication to individuals living with cancer. "We believe in life. Your life," is the opening of the group's manifesto. "You must not let cancer take control of it."

To help patients and survivors "in the fight of [their] life," Livestrong created and distributes a guidebook and planner that take on "the hard stuff" and "the practical stuff": how to ask for a second opinion, deal with insurance companies, live with chemo. The foundation's website, livestrong.org, features dozens of video interviews with survivors and caregivers of different ages, with different types of cancer, so visitors can hear from people like themselves. Planet Cancer, which Livestrong acquired last year, is the largest online cancer community for young adults; it explores how the illness affects dating, school, career, and other areas often overlooked by the cancer establishment. And Livestrong's SurvivorCare help line (866-673-7205) is a resource for anyone affected by cancer — patient, relative, or friend. Last year, 8,900 people called or emailed.

"I just talked to the mother of a 15-year-old with cancer," says help-line staffer Sarah Vauthier on a recent morning. "She wasn't sure how to preserve his fertility. And she wanted to know how to talk about it with him." Vauthier and her colleagues answer medical, financial, psychological, even child-care questions. They connect people to EmergingMed, which suggests appropriate clinical trials. And they put young adults in touch with Fertile Hope, a not-for-profit that the foundation acquired in 2009, to bank eggs or sperm. (Cancer patients who call the Livestrong help line get a discount on storage.)

Later this year or early in 2011, Livestrong will open a walk-in center at its headquarters to help patients navigate the convoluted world of cancer. It's inspired by a facility that board member and cancer luminary Dr. Harold Freeman opened in New York's Harlem neighborhood, which has increased early detection and lowered mortality rates in a low-income population. Ulman hopes to duplicate the navigation center elsewhere, especially in cities without a cancer institute. "A lot of medical institutions have something like this, but they're selfish," he says. "They're created to help people navigate their system. Ours is agnostic. We want to help you find the best answers wherever they take you."

As Livestrong has grown, Ulman and his team have developed a sophisticated business model. One particularly farsighted move is the deal with longtime partner Nike. Until this year, the foundation received 100% of the profit from Nike's Livestrong products — not just $1 yellow bracelets, but a line of Livestrong shoes, shirts, and bags — to the tune of more than $12 million in 2009. To give Nike an incentive to grow the business, Ulman offered to trade profits for a minimal annual contribution of $7.5 million for the next five years, plus a royalty on sales over a certain threshold. Nike marketed Livestrong heavily during the Tour and began introducing the products in Canada, the U.K., and France. A China launch could come as soon as next year. "Michael Jordan is a $1 billion-a-year brand, but it's been around for 27 years," says Ulman. "We're on year two or three, but we're eager and impatient."

The foundation has also branched out beyond Armstrong's sponsors. The most unusual venture involves Demand Media, which was hired to extend the brand into a healthy-lifestyle site. Livestrong.com attracts nearly 7 million monthly visitors and offers exercise videos, low-fat recipes, and a calorie-counting app for the iPad and iPhone. Livestrong, true to the venture-capital bent of its board, took an equity stake. Demand, one of the 20 largest U.S. Internet properties, according to comScore Media Metrix, filed for its IPO in August.

"It could give us stability for years," says Ulman. "I wake up in the middle of the night now wondering if we should sell."

Another step toward stability: moving away from a reliance on just one famous survivor. Last year, telenovela star and breast-cancer survivor Lorena Rojas became a Livestrong Global Envoy, joining a handful of other celebrities. She spoke at the global summit, hosted a fund-raiser in Miami, and appeared on the cover of the foundation's quarterly magazine. She's the ideal person, says Ulman, to improve outreach in the Hispanic community, where a shocking 68% of women don't think cancer is curable, according to a 2009 Columbia University study.

Livestrong's real forte has been creating a grassroots community that still supplies more than half of its $50.4 million annual revenue — and allowing that community to define the organization at the local level. Volunteers organize fund-raising events and support groups without approval from Austin. "If the brand is really authentic, it's theirs," says Ulman.

To maintain an ongoing dialogue with its supporters, Livestrong has mastered Twitter. "Social media has changed the not-for-profit world forever," says Ulman, who has nearly a million followers. "It used to be about how big your [mailing and email] database is. Now it doesn't matter. I'd rather have 10,000 people who are passionate than 3 million who aren't engaged."

★★★★★

As this story goes to press, Armstrong hasn't been called to testify before a grand jury. He hasn't been charged with a crime. But the ongoing investigation looms, generating negative attention for him and, by association, Livestrong.

For decades, cycling has been riddled with doping scandals, and there have long been rumors about Armstrong, which he has always denied. What makes the current inquiry more serious is that the federal government, not a cycling authority, is looking into possible criminal behavior. When contacted by Fast Company, the U.S. Attorney's Office in Los Angeles would not confirm the charges being considered, but The New York Times, citing unnamed sources, reported that investigators are exploring possible drug distribution, fraud, tax evasion, and money laundering.

"No one has told us [the possible charges]," says Mark Fabiani, a damage-control specialist (former president Clinton and Goldman Sachs were once clients) who joined Armstrong's legal team in July. "We only know what we read in the media. The prosecutors have leaked various theories over the past several months." Fabiani confirms that Armstrong's lawyers contacted prosecutors and met with them in L.A., but he declines to give details.

The investigation began last May, when Floyd Landis, who had been stripped of his 2006 Tour title after testing positive for performance-enhancing drugs, told prosecutors that he and his former U.S. Postal Service team, including Armstrong, cheated and even sold their bikes to pay for drugs. Now Landis has filed a whistle-blower suit that could help his credibility and net him millions if the government recovers ill-gotten sponsorship money. "This news that Floyd Landis is in this for the money reconfirms everything we all knew about Landis," Fabiani said in a statement about the suit. "What remains a complete mystery is why the government would devote a penny of the taxpayer's money to help Floyd Landis further his vile, cheating ambitions. And all aimed directly at Lance Armstrong, a man who earned every victory and passed every test while working for cancer survivors all over the world."

Armstrong's defense team may be willing to mention his cancer crusade — which critics see as a shameless ploy to absolve an accused cheater — but Ulman is determined to distance Livestrong from the inquiry. So when the Associated Press ran a story in August speculating about the inquiry's fallout on the foundation, he held an impromptu staff meeting, urging everyone not to get distracted. Like a coach motivated by trash talk, Ulman posted part of the article in his cubicle. He and Binswanger spent the day calling donors, business partners, and supporters and assured them that the organization was doing well. Participation, donations, and business partnerships were at an all-time high. The coverage hasn't hurt, insists Binswanger, but he concedes that "it's time-sucking."

That night, Ulman emailed the staff: "People are assuming we will fail to fulfill our mission... . They don't know the power of 28 million people. They don't know the dedication of our TEAM." The refrain, repeated six times — "Now is the time."

A week later, he brought in Katherine Jones, founder of Milkshake Media in Austin, to tell the staff how the Lance Armstrong Foundation became Livestrong. Jones described how her branding group, initially hired in 2004 to develop an online community resource, decided on a name inspired by Armstrong's "Fight like hell" approach to his cancer. The idea of living strong with cancer was so compelling to cancer survivors that Livestrong became its own brand. That was a seminal moment for the foundation. The explosion of Livestrong wristbands turned a $9 million organization into a $40 million one. It also triggered a strategic identity shift that Ulman and Livestrong are relying on today to weather its founder's legal troubles.

As close as he and Armstrong are — they've vacationed together and trained together for the New York City Marathon — Ulman says he has never asked him about the charges. "That's not where my focus is," Ulman says. "We wouldn't be where we are, a movement of millions, if we didn't have a visible founder and if he hadn't put the money and effort into this. The upside [of Armstrong] outweighs any potential downside." But, he adds, "as a cause and as an organization, we want to live beyond any one individual. Cancer is going to be around a long time."

★★★★★

By 7 a.m. on a Sunday morning, more than 3,000 cyclists are lined up wheel to wheel in a parking lot at Montgomery County Community College outside Philadelphia. They're about to ride anywhere from 10 to 100 miles in the Livestrong Challenge. Shortly before the start, Armstrong arrives by bike, wearing black and yellow Livestrong gear head to toe. He steps to the mike and thanks the crowd for helping raise more than $3 million.

At the starting line, melanoma survivor Marie Hejnosz waits for a glimpse of her husband, who's riding in tribute to her. When she was diagnosed 23 years ago, "I was a basket case," recalls Hejnosz, 54, a financial analyst at the Hospital of the University of Pennsylvania. Her mother told her not to tell people. It was taboo. Today is her first Livestrong event, the first time she's felt a part of the cancer community. "This is awesome," she tells me. "It's separate from whatever [Armstrong] did or didn't do with his body."

As long as the federal investigation continues, the doping allegations and the cancer crusade, the sordid and the inspiring will coexist. But none of the more than 50 people interviewed for this story, from survivors to sponsors to the head of the American Cancer Society, seems to believe Livestrong will be dealt a fatal blow. "If this had occurred before the foundation had a track record, it would have been a problem," says Indiana University's Lenkowsky. But now the organization that Armstrong founded has moved beyond him and his cancer. GE and Google reach out for Livestrong's expertise, not for Lance time.

"The key is to look forward rather than backward," says Julian Day, CEO of Radio-Shack. Beyond millions in team sponsorship, the company has made Livestrong its official charity and promotes it in more than 4,500 stores around the country. "Livestrong is a lot bigger than Lance."

After Armstrong finishes his 45-mile ride through the Pennsylvania hills and heads to the airport — his kids are starting school in Austin the next morning — cyclists continue to cross the finish line in the Livestrong Challenge. They're hunched over the handlebars, grimacing, raising their arms in victory. A survivor hands each one a yellow rose.

The announcers single out riders as if they've won the Tour: "She's a three-time Hodgkin's survivor! Wow!" "He's been battling cancer! In treatment for two-and-a-half years!" Kids are clanging cowbells, spouses are dabbing tears, and there are so many riders wearing yellow-and-black jerseys, teardrop helmets, and wraparound shades that Lance Armstrong appears to be everywhere. But he's gone, and they've got their own cancer stories to tell.

The beauty of what Armstrong and Ulman have created is that they don't need to be here. As the survivors cross the finish line and reach for a rose, they're having their own Livestrong experience.

Photograph by Glenn Kasin

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21 Comments

  • lanchangquan

    At the starting line, melanoma survivor Marie Hejnosz waits for a glimpse of her husband, who's riding in tribute to her. When she was diagnosed 23 years ago, "I was a basket case," recalls Hejnosz, 54, a financial analyst at the Hospital of the University of Pennsylvania. Her mother told her not to tell people. It was taboo. Today is her first Livestrong event, the first time she's felt a part of the cancer community. "This is awesome," she tells me. "It's separate from whatever [Armstrong] did or didn't do with his body."nikeshoes

  • Reid Rothschild

    Pharmstrong will be in prison soon and we'll all be able to read about his cheating and fraud.

    Reid Rothschild

  • nynetguy

    So, how did that work out for you spanky? It's two years later and the charges were just dropped. You should find a napkin to wipe that egg off your face.

  • led signs

    Well documented and beautifully written.
    Now referring to the last part of the article: it was a marathon of the brave and of the survivors.
    These are truthfully real people - they live life at fullest helping others in the process.

    LED Signs

  • Bill Hughes

    Fast Company has taken on an interesting journalistic investigation, however they have missed an opportunity to completely understand the motivation of Armstrong and Livestrong.com. If you had looked closely at the SEC documentation for the Demand Media IPO (S1) you would find some interesting data points.

    Simply put, Livestrong.org is the charitable organization, while Livestrong.com is a for profit venture. When Livestrong.com was sold to Demand Media, Armstrong was given warrants that allow him to buy 1,062,500 shares at $6/share after the Demand Media IPO. These warrants were issued in exchange for Armstrong providing “certain services and endorsement rights”. Demand Media is expected to go out at $12/share meaning Armstrong is expected to pull in over $6.3 MM in profit from endorsing the Livestrong name. This provides high credence to the argument that Armstrong’s comeback to the sport and specifically the 28 jersey incident were simply motivated by Armstrong’s obligation to promote Livestrong in exchange for his warrants.

    There is certainly nothing illegal about what Armstrong is doing but it does put in to question his altruistic motivations. His awareness effort for Livestrong clearly provides him a paycheck. Most importantly, you will not find any other high profile leaders at high profile charities participating in such nefarious activities.

  • Lives Strong the Vegan Way

    I am not sure that not being "proven" guilty means someone is innocent. It just means they haven't been proven guilty...speaking outside of legal terms of course.

    I am not sure that Livestrong will ever not be tied to Lance Armstrong...so perhaps the point itself is moot. I feel bad for those who work hard at Livestrong that Lance's potential cheating has distracted the public, and I think we are (for the most part) very skeptical of public relations gimmicks (which this article may appear to be).

    Regardless, Livestrong should be thanked for their work, and I truly hope it continues.

  • patti soldavini

    My prediction is that Livestrong will not be significantly affected by any potential adverse publicity for Lance Armstrong. The organization is already so MUCH bigger than him. What he has already achieved with Livestrong far outstrips his accomplishments in cycling. For years now, business can't get out of its own way to heal people. The healthcare/medical/pharmaceutical establishment is a monolithic collection of countless silos. Organizations like Livestrong are in effect "getting business out of its own way" so that cures and treatments are realized faster as opposed to suffocating under bureaucracy while people die. When I go into a doctor’s office and see the familiar “wall of patient records,” which are nothing more than archived transactions inside manila folders, it makes me sick. Imagine, doctor’s knowledge trapped, static inside paper folders in 2010. Instead, they should look at them as a form of “clinical trial.” Imagine proactively analyzing the data of all the patients in a practice instead of simply “filing records.” How quaint. God bless Livestrong, Lance Armstrong and Brian Singer. And the charges against Lance are a crock of shit. It is just a form of unsportsmanlike conduct sanctioned by a bunch of babies.

  • Guest

    If he's NEVER failed a drug test, how can you convict (or even accuse) him? What's the point? Is the World Cycling authority actually saying that you can be tried and punished on hearsay? Then what's the point of drug tests if all it takes is unified lies or exaggerations. Landis has no credibility - he failed drug tests and he lied about it. So why is his testimony being given such regard??? This just riles me to no end. LEAVE THE GUY ALONE unless you have a vile of urine (or two) that shows he used performance enhancers and don't elevate Landis above Lance. That is just plain stupid.

  • Bryan Coe

    Wow, FC you make it sound like Lance is already guilty. He won 7 the TDF 7 times. He is the biggest target for the sport if for no other reason, but for this fact. Floyd finally admitted his guilt after he lost everything, wife, money etc.. As a man that had nothing to lose he suddenly admits his guilt and implicates a bunch of other people. Sounds like he had some other motivation... most likely money. I smell a book deal.

    Anyway, Livestrong is not in question and if it does lose face because of the scandal it is in no small part because of the sensationalist headlines like this article.

    Sorry FC, I'm a longtime reader, but I think this one was in bad taste.

  • Fuyung Fuyung

    This whole investigation stinks of fish. There is a good article about the mope who is leading the charge against Lance in Outside magazine. Either way, if the burden of proof is a failed drug test, and there isn't any such drug test, then this should be over right. The science should be used to it's fullest extent. OH but now we're going to rely on hearsay, not any of the passed drug test, that the Cycling Federation and France were administering all those years, that an American was winning their fabled race. I'm baffled, and a little shaken, that so many cancer survivors may have to go through this.

  • Andy Anderson

    Frankly, I REALLY don't much care about possible doping questions, and I care less about an investigation which, if I understand it correctly, came about because someone who was a serial LIAR for years, suddenly came clean and admitted his [obvious] guilt and, no doubt in a effort to make himself look 'less bad', added a lot of accusations about others to his confession. WHY should anyone believe a clearly demonstrated serial liar??

    What DOES matter to me is a young guy who was diagnosed with testicular cancer in 1996, a young guy who, at a time when it really wasn't at all 'fashionable' to even admit to having cancer, had the BALLS to talk openly about his condition and his determination to fight. In the last 14 years countless hundreds of thousands of people, possibly millions, have found life-saving courage from that long-ago young guy and his courage.

    What also DOES matter to me is very personal - In May 2000, at almost 51 years of age, I was diagnosed with the same variety of testicular cancer as that young guy had almost four years previously. Although I'm in Ireland and he was in the USA, our treatments were directed by the same doctor [although I was unaware of this at the time]. While his bHCG level [ a hormone measure used as a guide to how much cancer a patient has in his body] reached 110,000 [at 50,000 your prognosis is definitely NOT good] mine topped 364,000, and just last year I learned that when I was presented for treatment, the BEST medical guess was that, at MOST, I had about SIX WEEKS to live.
    I remember being in hospital in Belfast for the third of four cycles of seriously-heavy-duty chemotherapy, it was 12th July 2000, and I shuffled very painfully up the ward to the Day Room to see that day's Tour de France programme on [UK] Channel 4. That day was a Rest Day on the Tour, so no 'fresh' action. That evening Channel 4 simply repeated their programme from two days previously, Monday 10th July. That day all the main contenders were together as the peloton reached the bottom of the Hautacam Mountain in the Pyrenees - that day's stage finish was at the top of the mountain - when one rider broke away from the main group. I'm sure it was a lot harder than it looked but he stormed up that mountain leaving his main rivals in the dust. At the top he took about SIX minutes out of his rivals and he took the Yellow Jersey which he held all the way to Paris. You really don't need me to tell you who that young guy was, but in case you're too young to remember, it was 'some guy called Armstrong'.
    Now picture the scene - there I was sitting in a hospital ward feeling VERY-seriously shitty, the bag of chemo drugs was slowly dripping its contents into my bloodstream, contents that were so toxic that if I scratched an itch I got brown 'burn' marks on my skin. There I sat - BUT with the knowledge that just less than four years previously he had been in EXACTLY the same position. While those toxic chemicals were medicine for my body, watching that ride was pure medicine for my soul. I didn't shuffle painfully back to bed once the programme was finished, I effortlessly glided!!!

    NO investigation or verdict can ever tarnish what Lance Armstrong has achieved for millions of people battling cancer. Personally, I really DO NOT believe he ever doped, he had FAR too much to lose by doing so than he could ever have gained. Maybe you have to have been through a cancer experience to fully understand - but for me there's just NO way he would have risked sacrificing his foundation and its good name, his reputation as a cancer advocate never mind his sporting reputation ... for me the 'young guy' is INNOCENT!!!

    There will always be detractors, there will always be those who are jealous of another's hard-earned success, and even when the Congressional investigation delivers its verdict there will always be doubters one way or the other. What does matter, and it deeply matters to the 28,000,000 people around the world currently battling cancer, and the added millions who have already successfully battled cancer is the courage of that youg guy back in 1996, who risked hugely to publically state he had cancer, and who, while still undergoing brutal treatment, had the courage, and vision, to determine to use his experience to help others ... and for the past 14 years has acted upon that determination - that's really all that really does matter!

    My apologies if I've rambled !!!

  • Chuck Salter

    Chuck Salter here at Fast Company. Thanks for reading my story and for sharing your experience here. Very moving. You expressed so well the attitude shared by many of the survivors I interviewed, including the folks at Livestrong - that the investigation is irrelevant in the fight against cancer. That's a perspective I tried to convey even as I posed the unavoidable question about the inquiry's impact on the foundation. Hopefully, by the end of the piece, you come to see how the foundation has been working for years to become bigger than its founder. A lot of foundations started by high-profile folks never make that critical leap.

  • Dan Tucker

    No apologies. An articulate expression of why the doping allegations don't really matter much if you've survived.

    L i v e S T R O N G

  • Karen Newcombe

    I find it very difficult to believe that one of the most highly studied, scientifically tested and continuously observed athletes in history could have found any opportunity to use drugs once, much less to do so on a consistent basis for the lengthy period of time that was needed to achieve what Lance Armstrong has done.

  • CEO_Nick

    I agree with Mark below, that Lance is innocent until proven guilty, but given the evidence we've heard from both sides it's hard to imagine how things will play out. There is no telling what this will do for the Livestrong foundation but it's hard to imagine much good can come from it.

    About a year ago my company was faced with falsified media ads slandering my business and this did shed a negative light on a lot that we were accomplishing. Never having faced this before I decided to call Action Coach, a professional business coaching firm and they really helped me get out of the mess. Anyway, if you want to look into them go to www.coachmybusiness.net

    It would be terrible to see someone, such a hero in the eyes of many to be brought down to nothing, so I hope for his sake and many of ours this is not the case. Do not immediately believe everything that you read.