Tests to detect steroids and other performance-enhancing substances are required of all Olympic hopefuls, and athletes are often tested numerous times and at varying intervals in their careers to ensure that no 'doping' occurs. Many athletes may find the tests a necessary but annoying part of competing, but for U.S. beach volleyball player Jake Gibb—who garnered fifth place as part of the U.S. team at the recent London Olympics —the tests were quite possibly a lifesaver.
In December 2010, a required blood test to detect performance-enhancing substances administered by the United States Anti-Doping Agency (USADA) showed abnormal levels of beta-hCG in Gibb's blood. Some athletes who use steroids take beta-hCG to reverse shrinking of their testicles, which can be a side effect of steroids. Gibb was suspended but told to call a doctor. That's because the main reasons for a high level of beta-hCG in the blood are pregnancy, steroid use, and certain cancers, as was the case with Jake Gibb, who had testicular cancer.
A biopsy confirmed the cancer, the doping suspension was lifted, and Gibb had surgery to remove the tumor. The surgeons were able to remove the entire tumor with no need for chemotherapy, and Gibb, who also was treated for skin cancer several years ago, joined the U.S. team in London.
The discovery of Jake Gibb's cancer was a rare find in the routine work of the USADA, an independent, non-governmental anti-doping agency for Olympic and many other sports in the U.S. The USADA conducts in-competition and out-of-competition tests. For out-of-competition testing, athletes are tested with little or no advance notice of the test; in-competition testing is usually conducted after an event. This type of testing falls into the category of "forensic testing" and is similar to the pre-employment or work-place drug testing that has become routine for many in the U.S. work force.
The USADA relies on a regularly updated list from the World Anti-Doping Agency (WADA) for prohibited substances and procedures, which the WADA and USADA refer to as "methods," and the prohibitions are based on these criteria:
- Potential to enhance or enhances sport performance
- Represents an actual or potential health risk to the athlete
- Violates the spirit of sport
According to Larry Bowers, PHD, chief scientist at USADA, urine tests can detect about 200 compounds, including steroids and other anabolic substances, erythropoietin, and substances that cause false-negative results (masking agents). Sports organizations specify which compounds they might be looking for, or the USADA can do a complete screen. Blood tests are used to detect a few substances that can't be detected in urine, such as CERA, a form of erythropoietin, and for illegal procedures such as "blood doping." This process involves transfusing an athlete with blood before an event to increase the number of red blood cells and enhance oxygen transport to muscles. This can be detected by measuring hemoglobin levels.
Athletes can be asked to submit to urine tests, blood tests, or both. Athletes selected for testing must provide a urine sample under the supervision of a doping control officer or witness. Blood tests are collected by trained phlebotomists.
Occasionally, results from forensic testing may extend beyond category boundaries and have medical implications for those tested. Usually, anti-doping tests do not have a direct impact on an athlete's medical care, but in the case of Jake Gibb, careful interpretation of the results led to detection and successful treatment of a potentially deadly disease.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Jake Gibb: Olympian & Cancer Survivor. TheONC. Available online at http://www.theonc.org/author.asp?section_id=1767&doc_id=248355 through http://www.theonc.org. Accessed August 2012.
US Beach Volleyball Player Jake Gibb Recovers from Cancer to Make Olympics - Twice. Washington Post. July 30, 2012.
Beach volleyball Olympian overcomes cancer, qualifies for second Olympic Games. July 25, 2012. Available online at http://www.jakegibb.com/press.html. Accessed August 2012.
United States Anti-Doping Agency. Athlete Guide to the 2012 Prohibited List. Available online at http://www.usada.org/prohibited-list/athlete-guide/ through http://www.usada.org. Accessed August 2012.
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United States Anti-Doping Agency. Blood Sample Collection Process. Available online at http://www.usada.org/blood/ through http://www.usada.org. Accessed August 2012.
United States Anti-Doping Agency. The World Anti-Doping Agency (WADA) Prohibited List. Available online at http://www.usada.org/prohibited-list/ through http://www.usada.org. Accessed August 2012.
United States Anti-Doping Agency. About USADA’s Testing Program. Available online at http://www.usada.org/program/ through http://www.usada.org. Accessed August 2012.
United States Anti-Doping Agency. 2011 Annual Report. Available online at http://www.usada.org/annual-report through http://www.usada.org. Accessed August 2012.
True Sport. What Sport Means in America. Available online at http://www.truesport.org/about/what-sport-means-in-america through http://www.truesport.org. Accessed August 2012.
Larry Bowers, PHD, chief scientist at USADA. Phone interview, August 2012.