Also, I remember reading that Peruvians have been using coca leaves to treat altitude sickness for centuries, and it works better than anything modern medicine has come up with. Has that “treatment” found its way to the Himalayas? You’d think so.

I agree that taking (megadoses of) corticosteroids before you show any symptoms sounds like pulling your reserve chute before you need it.

Mountaineers who summit 8,000 meter peaks (death zones) without supplemental oxygen are:
1. freaks of nature with ridiculous V02 max (see Viestur’s “No shortcuts to the top”)
2. Lucky; note the case of Iñaki Ochoa de Olza. His records included climbing 12 of the world’s 14 tallest mountains without the aid of oxygen or oxygen tanks — and yet he died of HAPE (High Altitude Pulmonary Edema) on Annapurna.

Thus, since no one is invicible from HAPE, and one’s tolerance can’t be predicted, people pack Diamox and other things to buy some time if things go wrong. Meds only help buy some time for descent. Remember, with altitude sickness, descent is the only possibility of recovery.

The meds people take before summiting are often sleeping pills, because it’s progressively difficult to sleep at altitude, and oxygen, because no drug will warm you like oxygen. Less than full flow from an oxygen tank + waiting in line on Everest’s Hillary Step + 30mph wind = frostbite even for the best mountaineer. Ueli Steck turned back from Everest’s summit in 2012, saying that without O2 his feet were getting cold and he didn’t want to lose toes.

I think the article’s example is an edge case, a serious one, but more caused by deluded newbies, than a chronic cancer among the traditional sportsmen. I doubt and have not heard of people taking serious meds for performance nor before they get sick; it’s just silly to pull your one reserve chute before you need it.