David Smith has decided to delay surgery on a life-threatening tumour in order to continue competing.
The Paralympian, 40, faces losing his life if he chooses not to have the tumour removed which threatens to crush his spinal cord.
But he could be left paralysed below the neck if he goes under the knife.
“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,” said the Scottish cyclist.
“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.”
Smith won gold in rowing for Great Britain at the London 2012 Paralympics and intended to take part in the 2016 Rio Games as a cyclist but was forced out of the event with a similar tumour.
He wants to pursue treatments in the United States, including genetic therapy, and told BBC Scotland: “What I’m trying to do is find alternative methods that can just buy me time.
“I’m trying to study the history of my tumour. 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, ‘okay, this is risking your life’ then I’ll have a surgeon ready and I’ll go into surgery.”
Smith recently completed a 740km cycle across the Alps and has set himself targets for the next year.
“I’d love to do another full season with the team,” he said.
“I have a dream of World Track Cycling Championships in March and the World Road Championships next year in August. I’d love to go to both of them.
“Tokyo Paralympics in 2020 is maybe a stretch too far.”