Thousands of miles from his Austin, Texas, home, endurance athletes coached by Bill Earthman are training for grueling, day-long tests of strength and stamina like no other: the Ironman Triathlon.


Bill’s athletes live and train in the U.S., the U.K., South Africa, Peru, Mexico and Australia. And they may travel to nearly every continent of the world to compete in Ironman Triathlon series events.


Participants first must swim 2.4 miles. Then, they immediately bike a 112-mile route. And finally, they run 26.2 miles. All in 17 hours or less, challenged by weather, waters and terrain unique to the venue — and by the body’s creeping levels of lactic acid that can cripple an athlete’s performance.


“You don’t want to work too hard or work too easy during an Ironman,” says Bill, age 50, a former Ironman competitor himself. “You want to find that perfect balance and finish with everything having been expended.”


Bill’s athletes count on him to teach, guide, mentor, cajole, encourage and inspire via a regular phone call or Skype. And to listen.


“They want to talk to me and talk about how they’re doing with their workouts,” Bill says. “We can talk about the training data we’re collecting. We talk about their diet regimens and the stress in their lives and the sleep they are getting. And I am really paying attention to their voice and listening for the stress in their voice. You can tell if they are recovering from their training or dragging. And we can talk about adjusting things if we need to.”


To talk and coach his athletes to peak performance, Bill needs his voice.


For a time in spring 2014, Bill feared his voice would be silenced. His voice got very hoarse and he was initially diagnosed with vocal paralysis. Upon further exploration by Bill’s doctors, cancer was found in his larynx, and some were recommending that his voice box be removed.


Coaching without his voice? Being a dad to two kids without his voice? There had to be other options.




Conventional radiation therapy didn’t make the cut. Buddies who had cancer on the tongue and back of the throat had regretted their conventional radiation treatments because of the side effects they had to live with.


In Houston, Texas, Bill met with Steven Frank, M.D., medical director at MD Anderson Proton Therapy Center. “‘Side effects from your cancer treatment could last a lifetime,’” Bill recalled Dr. Frank saying. “‘So, you want to do the least invasive cancer treatment possible and reduce the harm to healthy tissue.’”


Understanding the idea of spillover radiation or what doctors call “the integral dose” — radiation unintentionally hitting parts of normal healthy organs and tissue outside the cancer target — had a big impact on Bill. “Why shoot all this radiation into perfectly good cells?” Bill asks. “You use a rifle. Not a shotgun.”


Three rounds of chemotherapy reduced Bill’s cancer. Then, Bill underwent 33 rounds of proton beam therapy in summer 2014. Four more chemo treatments completed his cancer therapy.


He experienced some pain during his last two proton treatments, “but it was bearable,” he says. And nothing like the “complete nightmare” his friends had experienced during and after their conventional radiation treatments.


“And my bounce back was so quick after my treatments,” he says. “People [who had conventional radiation] said, ‘You’re going to need a feeding tube and you’re going to lose all this weight.’ But I gained weight.”


Still, Bill’s voice has changed. It’s deeper.


But he has it. And he can put his voice to use, raising and lowering it, using the power of inflection and pause to communicate his advice to the endurance athletes who have hired him. It’s the same voice he uses to be a good dad to his kids.