Valvano was diagnosed with bone cancer in June 1992.
Shortly before his death, he spoke at the inaugural ESPY awards, presented by ESPN, on March 3, 1993. While accepting the inaugural Arthur Ashe Courage and Humanitarian Award, he announced the creation of the "Jimmy V Foundation", an organization dedicated to finding a cure for cancer. One particularly poignant section of Valvano's speech is as follows:
To me, there are three things we all should do every day. We should do this every day of our lives. Number one is laugh. You should laugh every day. Number two is think. You should spend some time in thought. And number three is, you should have your emotions moved to tears, could be happiness or joy. But think about it. If you laugh, you think, and you cry, that's a full day. That's a heck of a day. You do that seven days a week, you're going to have something special.
Jim Valvano died less than two months after his famous ESPY speech and after a year-long battle with cancer. His tombstone reads: "Take time every day to laugh, to think, to cry."