The Art of Dying: Jonathan Pascual Defies Terminal Cancer as a Triathlete

Last fall, on an excruciatingly humid day in Kona, Jonathan Pascual joined fellow Ironman competitors to attempt what most people couldn’t even imagine: a 2.4-mile swim, a 112-mile bike race and a 26.2-mile run. Some 16 hours later, the UH Mānoa graduate made international news not just for finishing the world championship race, but for doing so with Stage 4 cancer.  

There’s no cure for the rare mediastinal paraganglioma that has spread to Pascual’s lungs and bones. Knowing that, the 50-year-old traveled from his current home in the San Francisco Bay Area to fulfill his towering goal. By doing so, he sent a message to other terminal patients about the power of believing in yourself and resilience. “You don’t know what you are capable of—just give yourself the chance,” he says. 

After all, he wasn’t a natural athlete; he describes himself as that “scrawny kid with asthma, made fun of by other kids.” He started running in elementary school, then took up swimming. After moving to Honolulu from the Philippines as a teenager, he completed the Waikīkī Roughwater Swim, the Great Aloha Run, the Honolulu Marathon and the Tinman Triathlon.

He was diagnosed with cancer in March 2022, and faced with a grim prognosis, considered quitting his job as a nurse practitioner and slowing down. But that made him feel weaker. “My body is used to moving, so I never really stopped,” he says.

Pascual now practices what he calls the “art of dying,” which he sees as carrying on with life—and giving back. “There are many people with cancer, some who are close to me, and I race for them,” he says. “I want to challenge the notion that Stage 4 cancer is a death sentence. Life does not end with the diagnosis. You can have a renewed life with meaning and purpose.”

For however long he has, he wants to be a force for good, spreading hope and inspiration to those tackling whatever seems impossible. He has plans for more triathlons, even an ultramarathon, and he’ll continue to work, helping lung transplant patients at a San Francisco hospital.

“I know my light will soon cease,” he says. “That may sound dramatic, but all I need is another fracture in my spine, and I’m done. Cancer is eating away at my bones, but I’ve accepted that and made the choice to keep going until I can’t. My modus operandi is defiance.”