Paralympian David Smith has decided to postpone surgery on a life-threatening tumour in the hope of competing at the World Track Cycling Championships in March and the World Road Championships next August.
It is the fourth time Smith has been diagnosed with cancer. Born with a club foot, he had already represented Britain in bobsleigh, karate and rowing when doctors first discovered a large tumour embedded in his spine in 2010.
Emergency surgery resulted in temporary paralysis. "My first goal of rehabilitation was just to be able to walk again; I had to walk again completely from scratch,” he told the BBC in 2011.
"I had access to the best physios, the best strength coaches, the best psychologists, so it just put the ball in my court to give it 110%, which I did."
In 2014, Smith joined British Cycling's Paralympic Academy programme as riding a bike didn't place so much stress on his neck.
He had planned to take part in the 2016 Rio Games as a cyclist but missed it due to a similar tumour.
He has now been told that if he doesn’t have surgery he will die, but if he does have surgery he could be left paralysed below the neck.
"Subconsciously I've created a plan that I will go as long as I can to the point I feel that I'm losing my limbs," Smith told the BBC.
"As long as I know what I can do, then I'm willing to still live my life in control knowing that if I have the surgery next week, I could wake up from that surgery and never move again. Then I'm thinking to myself, 'wow, I could have still had another year of doing what I love'.
"Every time I've gone for surgery the massive risk has been paralysis from the neck down, on a ventilator for the rest of your life. Some people do remarkable things in that situation. I'm not sure how I would cope in that situation. I don't think anyone can really say until they're in that situation. The unknown is very, very scary. This is known. I know what I can do day to day at the moment."
His dream, he says, is to compete at the World Track Cycling Championships in March and the World Road Championships next year in August.
“I'd love to go to both of them. The Tokyo Paralympics in 2020 is maybe a stretch too far."
With that in mind, he is researching alternative treatments that might buy him some time.
"I'm trying to study the history of my tumour,” he said. “What size has it got to each time we've operated and how big can it grow before it causes real problems? The body's an amazing thing – it wants to work.
"And even though there's this foreign body growing in your body, your body's still fighting it, trying to regain a normal status. As long as that balance is in my favour and I can still ride and I can still breathe and I can get around then I'm not going to rush into surgery.
"That might buy me four months. It might buy me four years. If I scan every month or every two months, we can track it. If it's got to a point where it's like, 'OK, this is risking your life' then I'll have a surgeon ready and I'll go into surgery."