UNDER two years ago, David Smith was barely physically able to brush his teeth. Though he is too modest to admit it, that he will be on the start line representing GB at the UCI para-cycling Road Race World Championships this week is something of a miraculous achievement, and testament to his determination and drive.

The 40-year-old has had quite a time of it over the last few years. In 2012, Smith, from Dunfermline, won Paralympic gold in rowing at the London Games, despite in the build-up to those Games being diagnosed with a tumour in his neck which left him unable to walk.

In the aftermath of London 2012, he turned to cycling but his tumour returned, with the resulting surgery yet again leaving him paralysed. Rio 2016 remained a very real possibility but when another tumour was discovered in the months ahead of the Paralympics, he was forced to accept he must undergo yet another surgery. This was the worst yet and he admitted himself that he doubted he would ever return to top-class sport.

This would have forced most mere mortals to accept that elite sport was no longer for them. But not Smith. Slowly but surely, he rehabilitated himself back to fitness. Another GB selection, though, seemed close to impossible.

But Smith’s persistence is remarkable and earlier this year, he was selected for GB to return to racing, at a World Cup in Belgium in April. He was not challenging for the win as he might have been in the past but it was remarkable progress. That improvement has continued over the summer, with his selection for the World Championships, which begin today in Italy, the culmination of hours of painstaking rehabilitation.

Smith admits himself that his recovery has been remarkable. “After that last surgery, it’s just about being here racing,” he said.

“If someone would have told me six or eight months ago that I’d be at the World Championships, there’s no chance I’d have believed them. This time last year I wasn’t even on a bike. I think back to those times in Stoke Mandeville Hospital and I couldn’t even brush my teeth and that’s not all that long ago.”

Smith’s journey to this point is remarkable but he admits that it is only recently he has been able to sit back and fully appreciate what he has been through and the remarkable progress he has made, and continues to make.

“I can get perspective on things now," he said.

"Four or five years ago, I couldn’t – I was so focused on cycling but after being in hospital last time, I had so long to absorb what was going on, I was able to start appreciating everything. And I’m a little bit older and a little bit wiser so I’m able to see things from a slightly different angle now. I’m able to remove myself and I can see that it is only sport.

"It’s very important to lots of people but it is only sport and life is much more precious than getting so absorbed in racing. When you do become so absorbed, you become unhappy doing what you’re doing. And at the end of the day, when you’re happy you perform better. So now, I feel like I’m better at pulling myself away from it and have the attitude of what will be will be."

Smith admits he goes into this week’s World Championships with modest expectations of himself. He has, after all, only able to begin training as he would have liked recently and will be up against riders who have been targeting this event for months, if not years. However, British Cycling do not hand out caps for free and so Smith has obviously proven himself to be worthy of selection.

However, his main goal is to make the most of this experience, particularly when he knows that on his return from Italy, he has more scan results waiting for him, and he doesn’t know what news to expect.

“When you know you’ve got results like that waiting for you, it really reminds you that you’ve got to just enjoy these experiences. So I’m just going to enjoy going out there this week and suffering for 20, 25 minutes in 30-odd degrees because you never know when it will end.

"When I got the news that my scan results were ready, I didn’t even really process it. I just thought to myself well, I feel really health so I just can’t believe I’d be ill.

The 9th of August will be horrendous but whatever happens, you just have to deal with it. It makes me realise that not a lot of people get the opportunity I’m getting and ultimately, it’s about creating memories for yourself and enjoying the process of doing that.

"If you can come away with a decent result then great but as long as you come away knowing you’ve given everything, that’s all I can do.”