So here is the dilemma. Seven weeks before the start of the Olympics, you sit in a doctor's office to be told that you have testicular cancer. You need an operation, but to go under the knife will cost you any chance of competing in China and fulfilling a lifelong dream.

These are not just any Olympics, they are your one and only shot at glory. You missed out on Athens four years ago by a whisker, and younger guys will come swimming past you by 2012. It is Beijing or bust, baby.

Do you chase a medal or opt for immediate surgery? Do you travel to China and try to compete against the world's best, knowing that a doctor is waiting for you back home in America with a scalpel?

That was the dilemma facing Eric Shanteau and suffice to say that yesterday he was not recuperating at home but plunging into the pool at the Water Cube in the heats of the 200 metres breaststroke. He was seeking a place in tomorrow's final and if you want to adopt any non-British athlete, how about the man who will never win as many medals as Michael Phelps, but who is being held up as just as much an inspiration from these Olympics? “It was a dream come true just to race here,” Shanteau said, still breathing hard and dripping after his first race yesterday. And we could forgive the cliché, coming from the lips of a 24-year-old for whom just taking part truly is an achievement.

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This is an athlete whose schedule this week has included a CT scan and blood screening to check that his cancer has not spread. And as if he has not had enough to contend with, his father is fighting his own battle with lung cancer.

The first thing that Shanteau did yesterday after coming second in his evening heat - “the longest day of my life,” he said - was look to the stands to acknowledge his father and the rest of the family who have followed him to Beijing. They have shared the journey from the day in June when Shanteau felt a pellet-sized lump on one testicle. His girlfriend told him to see a specialist. Cancer was the diagnosis.

“Two questions leapt into my mind,” he said. “One was 'why me?' The other was 'Why now?'” Why, just as he was trying to realise the great ambition of his life, was he faced with its greatest crisis? “My first instinct,” Shanteau said, “was to reach over the table and punch the doctor who was giving me the news.”

The doctors gave him the option of immediate surgery, or monitoring his condition. They assured him that his kind of testicular cancer is slow growing, so he opted to postpone the operation, accompanied by weekly testing. “If certain tests had come back elevated, my parents would have stepped in,” he said.

But first he had to qualify for the Games, not easy when he was weighed down by a sackful of troubles. He went to the trials in Omaha, Nebraska, and finished second, recording a personal best in the process. How is that for mental fortitude?

His restrained celebrations surprised his team-mates, who thought he was a bit blasé about finally getting to the Olympics. It was only a couple of weeks later, when the team gathered for the pre-Games training camp in California, that Shanteau decided to stand before them and reveal his illness.

And so a swimmer who would normally expect to be on the margins of the United States squad has become one of the most uplifting stories of the Games. He has been bombarded with good luck messages, including from Lance Armstrong, the seven-times Tour de France winner, who recovered from life-threatening cancer.

Ahead of him lie some testing days, but he is determined to enjoy himself in Beijing both in and out of the pool, hanging around for the weekend and then heading home for his operation a week later in Atlanta, Georgia.

He confesses to moments of stress around the Athletes' Village. “This isn't just the flu, it's cancer,” he said. But then he dives into the water and all his worries are temporarily washed away. “At this point, swimming is how I escape from it,” he said. “Swimming is like a vacation for me.”