Pinoy athlete with rare stage 4 cancer nails Ironman dream finish
Jonathan Pascual was out of breath and out of time.
Last Oct. 26, as he was swimming through the waters of Kailua Bay in Hawaii for the 2024 Ironman Kona World Championships, blood continued to slowly pool on his head. Pascual’s breathing got harder with every turn as malignant tumors near his neck and chest blocked blood-flow to his brain. As he checked his watch, he saw he just had less than an hour left to get back to shore.
“I was struggling. I was short of breath,” Pascual, a nurse who hails from San Jose City, Nueva Ecija, told PhilSTAR L!fe.
Pascual has stage 4 mediastinal paraganglioma, with tumors that have metastasized to other parts of his body such as his bones. Swimming is exponentially harder for the 50-year-old Pascual as the tumors disrupt normal blood-flow in a prone position, making just breathing difficult. He managed to cross the turnaround point of the 3.8 kilometer swim after over an hour and twenty minutes. With another 1.9 kilometers left to cover for the swim before the two hour and twenty minute cutoff time, Pascual needed to swim much faster than he did in the first half in order to make it.
Cutting it close
As a sweeper atop a surfboard appeared to guide him, meaning he was dead last on the course, Pascual dug deep to chase the tail-end of a two decades-long dream from disappearing before his salty eyes.
“If you did the math then, it would have taken me about three hours to finish the swim so I thought ‘Oh my god, I am not going to make it,’” Pascual said.
“But I just trusted my self. I kept on pushing. I focused, and dug deep.”
Having swam and trained on the course, Pascual knew there was a current he could ride on back to shore. After crawling and some flipping over to catch his breath, Pascual got to the shore, purplish face and all, just two minutes shy from the cutoff time.
“My face was just enormous,” Pascual said. “Pero nung nakatungtong na ako sa lupa at marining na dalawang minuto pa ang natitira, dun ko na lang pinayagan ang sarili ko na maging emosyonal. Napaiyak ako dahil alam ko na mayroon akong tsansa na matapos itong Ironman dahil alam ko na malakas ako sa bisikleta at pagtakbo.”
Purpose and peace
Being diagnosed with a fatal disease is not Pascual’s first brush with mortality.
In 2007, he went under the knife to remove a brain tumor. The experience led him to study and practice stoicism, a philosophy that started in Ancient Greece espousing the belief of virtue as being key to a well-lived life.
“What that taught me is to look at death everyday not in a morbid sense of way, but how [to] live my life such that I am living it with purpose and with peace,” said Pascual.
As a clinician, Pascual also devoured every information he could get about his disease, reading books, journal articles, and other works to better understand his situation.
“From all of those readings, I came upon this thought that I need to have this new job, which I called ‘cancership,’ and that job had to uphold the pillars of medicine: exercise, rest, nutrition, and support systems. So I have to devote time to those pillars so I can live my life as best I can. I think I have done a good job because it has led me to two years of living a pretty meaningful and active and loving life,” said Pascual.
Setbacks
Before signing up for the World Championships, Pascual had already been active in the sport for about two decades, having completed 15 full Ironman triathlons prior. But the symptoms manifested in 2021, as he was in the thick of training. He experienced sudden shortness of breath, an oddly swollen face even if his body was fit, large veins appearing on his neck, and suddenly fainting when getting up from a sitting position.
From the tests following the onset of symptoms, Pascual said he knew what was coming.
“I knew I had cancer even before the doctor told me,” he shared. “But it was pretty surreal. But I was not shocked, I was not emotional or angry. I felt full acceptance and serenity even.”
The 2022 diagnosis came with a five-year prognosis. Though the thought of slowing down and just traveling the world did cross his mind, he ultimately decided to continue doing the things he loved, including triathlon.
“I have to rebuild myself to the point where I can do this again. I told myself ‘Jonathan, you do not know what you are capable of doing,’” he recounted.
Just months after the diagnosis, another major setback happened when Pascual broke his back in the same year after the cancer made his bone weak, forcing him to have surgery. But just a month later, he tried to have a short run. And at the end of that year, he even had his first trail run.
“I allowed myself to run again. Being an athlete for over two decades, I knew it would take consistency and time,” said Pascual.
To endure the rigors of training as a stage 4 cancer patient, Pascual said he needed to accept that he is no longer the athlete he once was.
“Kinailangan kong matutunan na i-let go ‘yung dati kong sarili na malakas at mabilis na atleta,” said Pascual, whose best Ironman finish was about 11 hours.
“On those days when it gets really hard to even get out of bed, I allow myself the grace to say ‘It’s okay to do less today,’” said Pascual.
“However, I also allow myself at times to also just see what I can do, to get out of the house, start walking, jog, just do one mile or two miles then that’s it, that is being gracious to yourself and accepting your limitations,” he added.
In addition, Pascual also credits his very supportive and enabling wife, Monette, who encourages him in his pursuits.
“She is the backbone to all of these. She is the one who supports me when I am really aching,” he said.
Finish line
Every setback, sacrifice, and support eventually culminated in Kona for Pascual.
But after the grueling swim, Pascual still needed to overcome a pair of challenges before reaching his dream finish. At the aid station on the bike course, his nutrition bag was misplaced, leaving him and some volunteers to scrounge for extra supplies, thereby losing precious minutes.
Then on the way back, he passed by a fellow athlete bloodied on the side of the road following an apparent bike crash. As a medical practitioner, Pascual said he dismounted to provide aid to the injured participant. The Ironman bus eventually arrived with a doctor on board, but even if he lost about 45 minutes, he said it was perfectly okay.
“When I was riding back, I told myself, ‘Jonathan, race lang ‘yan. It’s okay,’” he recalled.
After finishing the bike course, Pascual said he really pushed himself on the run.
“The run was the best for me because I never slowed down, my pace was very even, even if it’s pretty slow,” said Pascual.
As he stepped on the gas for the run course, he finally arrived at his dream finish line at 11:45 p.m., well ahead of the 12:30 a.m. cutoff. He finished the Ironman Kona World Championships in 16 hours and 12 minutes.
“That is my slowest ever, but it’s my best finish ever,” Pascual said with a smile.
Full circle
It was full circle for Pascual, after seeing Dick Hoyt pushing his son with cerebral palsy throughout the entire length of the Ironman course all the way to the finish line on TV in 1990. Over three decades after, Pascual lit up the triathlon community himself after the Ironman organization posted about his successful finish and the ordeal he suffers from on their social media account.
Pascual opened up that he has dreamt about his Kona finish line moment a number of times before fulfilling it.
“In that movie in my mind, I am running towards my wife, my son, my mother, and that is exactly what happened,” he said. “It was just pure joy.”
According to Pascual, he owes much to his wife, and to his tribe that has been supporting him.
“Ironman became a symbol not just of me fulfilling my dream but I was thinking of all the people who helped me get there, who believed in me that I can do this. I believed that I [was] running also for the people who have lost their lives because of cancer, and I was running for the people who are still fighting cancer. In other words, the symbolic race was bigger than me. I was running for a bigger purpose,” he said.
After realizing a lifelong dream in Kona, Pascual said that as long as his body permits him to, he is not about to slow down just yet. Though he is aware that his symptoms will inevitably worsen over time, he said he intends to continue doing the things he love with the people he loves most.
He also professes abiding by “Ars Moriendi,” which is Latin for “The Art of Dying.” Through this, Pascual said he intends to spend his remaining time with purpose, love, and care.
Though his cancer may leave him out of breath and out of time, Pascual is never out of grace and gratitude.
“People are not going to remember all these things I have been saying or the work I did, but maybe some of them will remember the time I spent with them, and to me, that is far more important," said Pascual.
