A medical device system and associated method are used for monitoring tissue oxygenation. An optical sensor produces a signal corresponding to tissue light attenuation. A processor receives the optical sensor signal and computes a first measure of light attenuation at a first light wavelength and a second measure of light attenuation at a second light wavelength. In one embodiment, noise cancellation circuitry receives the first measure and the second measure and generates a guessed ratio of the first and second measures. Using the first measure, the second measure and the guessed ratio, the noise cancellation circuitry provides a peak output power when the guessed ratio corresponds to an actual ratio of the first and second measures.