Oprah: What's a great diet for you?

Lance: It has nothing to do with America's low-carb craze. I'm a heavy pasta eater. You can't ride six hours a day and not eat carbs. Before a training ride, I'll have a big bowl of muesli with soy milk, maybe some toast.

Oprah: Do you look at your life as B.C.—before cancer—and A.D.—after diagnosis?

Lance: Absolutely. October 2, 1996, is the day everything changed for me.

Oprah: Before that, weren't you coughing up blood?

Lance: Yes—that was an extreme sign.

Oprah: If I see a hint of blood anywhere, I'm like, "Oh my God!" Didn't your testicles get bigger?

Lance: One of them.

Oprah: That ought to tell you something!

Lance: I'm so hard-headed.

Oprah: It must have been painful to ride.

Lance: I was sore. When you're in your early 20s, that's not something you want to go around talking about.

Oprah: Tell me about the day you were diagnosed.

Lance: I went to the doctor and he felt around and then sent me to a radiologist for an ultrasound. That took an hour. Then the radiologist said, "I also need to do a chest X-ray." At that point I was really scared. When he brought in the X-rays, I got in his face: "Dude, what's going on?"

Oprah: Because by now you've been there two hours.

Lance: He said, "You need to go back to your doctor's office." Then he said, "Look, I don't want to get in your doctor's way, but this looks like it could be testicular cancer." So then I had to drive back with the X-rays on the seat beside me.

Oprah: I'll bet that's an out-of-body experience. In your book, you say that white on an X-ray means "not good," and yours looked like a snowstorm. What did you say when you heard the words "You have cancer"?

Lance: I said, "Are you sure?" He said, "I'm so sure that I've scheduled surgery."