Jonathan Pascual’s Story

I want to shatter the misconception that a Stage IV cancer diagnosis is an outright death sentence. For some, and hopefully for all in the future, cancer can be managed like any other chronic disease. I was diagnosed with Stage IV mediastinal paraganglioma on March 24, 2022, with a five-year prognosis. God willing, with the support of my medical team, the love of my family and friends, and my unwavering dedication to staying fit and strong, I will surpass those five years.

In early 2022, while training for the Kona Ironman Triathlon and ultramarathons, I started experiencing shortness of breath, dizziness, loss of consciousness, and facial swelling. Despite becoming fitter, I could no longer ignore my worsening symptoms. Tests revealed I had a rare cancer called mediastinal paraganglioma. It had already spread to my lungs and bones, extensively affecting my superior vena cava and causing superior vena cava syndrome, the culprit behind my symptoms. There is no cure, no surgery, only the hope of control and stability through treatment. Since then, I have undergone radiation, targeted therapy, surgeries for pathological fractures in my spine, chemotherapy through a clinical trial at the National Institutes of Health, and a stent placement to the superior vena cava for worsening symptoms.

Despite this, I refuse to let cancer dictate how I live my life. My background in endurance sports—triathlons, ultramarathons, and extreme endurance challenges—has helped me weather the physical toll of treatments. I believe that continuing to do what I love allows me to better manage the disease and face future treatments with resilience. That’s why, I continued racing—road marathons, trail runs, ultramarathons, triathlons, and swim runs.

In October 2024, I achieved one of my greatest milestones: completing the Ironman Kona World Championship Triathlon, a grueling 2.4-mile ocean swim, 112-mile bike ride, and 26.2-mile marathon. This event became a symbol of my fight against cancer. I raced not just for myself, but for those still battling, and in honor of those who have lost their war against cancer. My finish at Kona was an act of defiance, one that resonated with people around the world, inspiring and offering hope to millions.

Unfortunately, my health took a sharp decline in December 2024 due to blood clots in my lungs and deep veins, a direct consequence of the cancer. A PET scan in February 2025 showed further tumor progression throughout my bones and lungs, worsening my symptoms including pain and neuropathies. Despite the chemotherapy in 2025, my health continues to decline.

For the past three years, I have also organized JP’s Backyard Ultra, a fundraising event at Skyline Wilderness Park in Napa, CA, benefiting a nonprofit cancer foundation. This event has been more than just a race. It has been a powerful convergence of communities, a space where stories of resilience, loss, and triumph intertwine. It has brought together people from all walks of life, united by their love for the outdoors and their shared experiences with cancer. My goal was to give back to those who have supported me, but once again, my community's generosity and strength have made this event a resounding success.

Now, I invite you to join me for JP’s Backyard Ultra 2026, The Final Edition, on September 26, 2026 and support a cause close to my heart. Donations will benefit the Pheo-Para Alliance, a 501(c)(3) nonprofit organization (EIN: 26-1510652) dedicated to research, education, and support for those affected by pheochromocytoma and paraganglioma. Together, let’s continue to fight, inspire, and give hope.

~Jonathan Pascual

Media:

CBS Mornings feature "Note to Self": https://youtu.be/My2lIAjwTWo?si=sacKYTkDbKJXRORw

Press Democrat: https://www.pressdemocrat.com/article/napa/cancer-napa-ucsf-pascual-ultramarathon-ironman-hawaii/

NBC Bay Area, Bay Area Proud Series: https://www.nbcbayarea.com/news/local/bay-area-proud/north-bay-triathlete-facing-terminal-diagnosis-tackles-dream-race/3721497/

Listen to the P.E.A.C.H. Podcast and their take on JP's Backyard Ultra: https://podcasts.apple.com/us/podcast/peach-podcast/id1750551883?i=1000740971760

News Nation Now: https://www.youtube.com/watch?v=RcGiTiaoRhI

Good Morning America: https://www.instagram.com/reel/DB2DUYnvEft/?igsh=MzRlODBiNWFlZA%3D%3D

ABC News: https://abcnews.go.com/wellness/story/man-terminal-cancer-diagnosis-completes-ironman-world-championship/?id=115383346

Hawaii News Now: https://www.hawaiinewsnow.com/video/2024/11/02/fight-finish-hawaii-man-diagnosed-with-cancer-finishes-grueling-ironman-race/

Honolulu Magazine: https://www.honolulumagazine.com/jonathan-pascual-ironman/?utm_campaign=feed&utm_medium=referral&utm_source=later-linkinbio

The Patient Story, YouTube:  https://youtu.be/FIFgb40lWg8?si=QrzeckWC8CujnuO_