I’ve rehearsed for this, so I am ready.
Running 22 miles was a better option than waiting in the ER. But I listened to my friends in UCSF to get an echocardiogram right away. Even though I was getting stronger, leaner, and running longer for my upcoming ultramarathon and Kona World Championships, the signs and symptoms were worse.
My face swollen in the morning, waking up gasping for air at night, a fall from dizziness, and neck veins distended were progressively getting worse over the last three months.
I looked at my chest X-ray on my phone and I knew the mediastinum was abnormal. I looked at my chest CT scan and I knew I had cancer. Throughout all of this process, I’ve had only calmness, serenity, inner peace and acceptance. As a stoic practitioner, I look at death everyday. I’ve had a brain tumor in 2007 and have met my mortality many times.
The first five days in the hospital I just felt at home receiving the best care in UCSF. Twenty-two years of working in UCSF, I knew everyone and it did not matter the title on the badge. I was treated as family.
The paraganglioma in my mediastinum has metastasized to my ribs, lungs, spine, and hip. I walked the different floors of the hospital, did yoga at the courtyard, and allowed visitors from morning till night. It was a time of giving and receiving. The support and love was overflowing and I could not ask for more.
Tomorrow I will find out from my oncologist of the chemotherapy plan. I will know of the radiation plan on Tuesday.
The last few days have been filled with spending time with family, friends and loved ones whether that’s on the phone, text, or in person. I am maintaining my strength by doing walks, indoor cycling, and band workouts. I’m reeling myself in so as not to exert myself too much. I know the subtle changes in my body and I acknowledge the presence of the left rib metastasis, the shortness of breath when climbing a hill, the tiredness that comes in the afternoon.
We’re building a team to help me through this. Everyday I focus on the pillars of Medicine, Complementary Medicine, Nutrition, Exercise, Rest, and Support Systems.
If you wanna know how I’m doing, simply reach out.
March 24, 2023 marks one year of my #cancer diagnosis. I wish for this day to express my #gratitude to the celebration of the life that I’m living, my family, friends and my community.
I’ve always been drawn to difficult tasks that may seem impossible at first. Receiving the diagnosis was confusing and uncertain. Yet I remember that from the very beginning I was already in a place of acceptance as if I knew this was coming.
I had several premonitions including seeing myself in a hospital room talking to a hospital chaplain whom I know. That vision became a reality. Another occasion was when I remarked to a friend while I was strolling Chrissy Field beach to “feel the cold water wash over your feet”, “feel the wind touch your face”, “inspire the scent of the sea”, to remember all of these sensations, because I felt that my time was fleeting. And finally, I remember this occasion when the feeling of mental and physical exhaustion washed over me, I told myself that “I have lived a full life. I’m ready.” Ready to meet my end.
I remember telling myself to “take courage” in my hospital room one year ago. Courage is a legacy that my father bestowed upon me. The courage allowed me to see my situation as yet another impossible task. It is a place that I am familiar with for that is how I regard my 100 mile runs and Ironman triathlons. I simply needed more information, ask questions, formulate a plan and then execute. I devoured books on cancer and read journals on metastatic paraganglioma. The acceptance was a result of my stoic practice of thinking about death everyday since 2007 when I was diagnosed with a #braintumor. Acceptance gave me the clarity that I need to be strong to carry my family and those whom I care for.
One year hence, I realize that I was the one who was carried by my village. So to all of you, my family, friends, colleagues, those here and abroad, I say that you made this year possible. I would not be here if it were not for all the love you have shown. My heartfelt gratitude to all of you. A million thanks.
@fxckcancer
#cancersucks
#paraganglioma
#stageivcancer
@fxckcancerenduranceclub
#myvillageisstrong
#friendships
#family
@ucsfhealth
Jonathan Pascual (@jpconbrio ) is a triathlete who is battling stage 4 cancer while achieving incredible feats in the world of endurance sports.
In a note to his younger self, the @ironmantri reflects on his journey — and the importance of living life to the fullest: “Living well and dying well are deeply connected.”
ISR x lululemon x JP’s Backyard Ultra Training Run/Hike at Skyline Park.
We had a fantastic turn out to our first training run @skylineparknapa for JP’s Backyard Ultra and Hike.
We all come from different athletic and running backgrounds. However, it is best to be prepared for the rocks, roots, gravel, climbing & descending on the trails so it’s not too daunting on race day.
People new to the course were pleased they participated because for some of them, the trails are a new experience. We had plenty of tacos and cool drinks afterwards.
Future dates:
⏰ Time: 10 AM – 12 PM
📍 Location: 2201 Imola Avenue, Napa
Training Days + Tacos
• June 28
• July 26
• August 30
• September 20
Additional Training Days (no cookout)
• June 14
• July 12
• August 16
Remember it’s not just miles. Train for strength and mobility and visit @innerstrengthresearch website and IG for the free strength and mobility training.
Thanks to @lululemon Napa and @scarlettgoesoutside for the lululemon giveaway.
And thanks to @edubalbuena and Mr. & Mrs. Jay Denna for the tacos and cookies!
Run club leaders, please share these dates with your members and help spread the word.
We have a little over 200 signed up. But it’s through word of mouth, sharing in your stories, & reposting this post so we’ll exceed the 600 participants last year and hopefully generate more donations.
Remember, there’s plenty of raffle prizes and give away on race day.
If you haven’t signed up yet, go to my link in bio to sign up for
1. JP’s Backyard Ultra and Hike, a cancer fundraiser for the nonprofit @pheopara .
2. Training run series (EventBrite)
#trailrunning #hike #ultrarunning #beaforceforgood #paraganglioma
In this monthly series leading up to JP’s Backyard Ultra & Hike, we want to recognize and thank the many partners, sponsors, small businesses, organizations, and companies who continue to believe in this event and its mission. Your generosity and support over the years have helped turn this into something far bigger than a run.
And yes… get ready to win some fantastic prizes.
On September 26, 2026, we’ll have:
• Raffle prizes and gift baskets
• Specialty auction items
• A wine auction featuring incredible donations from Napa Valley wineries and winemakers.
All proceeds will benefit the Pheo Para Alliance, a 501(c)(3) nonprofit (EIN 26-1510652) dedicated to supporting patients, families, and medical professionals affected by pheochromocytoma and paraganglioma through education, advocacy, and global support. Learn more at .
Whether you’re aiming for 1 or 2 loops, pushing for 4, or taking on the full 10 loops, you’ll be supported by an aid station and lunch buffet unlike any other.
I’m tagging our partners and sponsors here and in the comments. My heartfelt thanks to every single one of you for helping make The Final Edition of JP’s Backyard Ultra & Hike the best one yet.
Next month, we will highlight our other partners and sponsors. So stay tuned for more prizes!
Be a force for good.
~Jonathan Pascual
Race Entries:
@scenaperformance@wildflowerexperience@napa2sonomahalf@baytrailrunners@norcalultras@alphawinracing@vacationraces@napaspringhalfmarathon@insidetrail@angwintoangwishtrailevents
Local Napa Businesses:
@chefshouserentals@deucesmarket@squeezeburgernapa@massageenvynapa@taqueria_rosita_napa
Nob Hill Foods
Tarla Mediterranean Bar and Grill
Walsh Vineyards Management
Vicor Restaurant Supplies
Johnny on the Spot
Specialty items for auction:
@hdrop.tech@sbrsportsusa@hoka@mounttocoast@brooksrunning@waterboycan
Scenes from Singapore.
This is a short reflection on travels and memories.
Over the years, I’ve realized I am not simply taking photos or videos. I am preserving a life. The people I love. The places I’ve been. The ordinary moments that later become extraordinary because time has passed.
Sometimes I look back at old videos and I am left in awe that we made any of it happen at all.
So capture it. Share it or don’t share it. But by God, capture it.
One day, those images will remind you not only of where you’ve been, but that you truly lived.
#singapore🇸🇬
#paraganglioma
One of my greatest lamentations has been realizing I could no longer tend the garden the way I once did. The body that trained for Ironmans and spent hours working in the yard now gets winded with even minor effort. The upkeep had to be handed over to someone else.
But still, I see flowers in my garden.
This spring, simply smelling the blooms and beholding their beauty has been enough to bring me joy.
My love for orchids began with my parents. I watched my father care for orchids brought from Bangkok, and to this day my mother still keeps orchids in her garden and her flower lei shop in Travis began as an orchid store.
Their love for growing things became mine.
They grew different crops in the Philippines. I studied horticulture in high school and we brought home the vegetables from our garden.
Oh, how I wish I could harvest vegetables from my garden once more.
In the early years of our marriage, I would often buy flowers for Monette from a flower stand on 19th Avenue in San Francisco. Over time, I told myself there was no need anymore. We had roses blooming in the garden.
Before our Singapore and Thailand trip, I asked Monette to cut roses from the garden and place them in a vase.
Now it is she who brings me flowers.
One of the most memorable moments from Singapore was walking through the National Orchid Garden with Monette.
I have no qualms admitting my sentimentality. I love flowers. I love orchids. At home, when my orchid withers, the joy becomes tending to it again, patiently waiting for it to flower once more.
Perhaps that is why gardens move me so deeply.
They teach us about time itself: growth and decline, blossoming and decay, beauty and impermanence.
Life asks the same thing of us: nurture what you love while you can, receive the beauty while it blooms, and learn to let go with grace when the season changes.
Perhaps this is my autumn season. Perhaps it is my winter. And just as flowers bloom and wither in their own time, I am learning to accept that letting go, too, is simply part of life.
#nationalorchidgardensingapore
I wanted to reconnect with my cousin Poppee when I visited Thailand.
She has undergone a mastectomy and chemotherapy. But the HER2+ breast cancer with nodal involvement still carries a recurrence risk that now requires adjuvant targeted therapy to reduce that risk even further.
I can only imagine the continued hardship of undergoing treatment every three weeks and managing much of it alone.
There are five of us Pascual cousins afflicted with cancer. Sienna died of lung cancer. Gigi is undergoing treatment for breast cancer. Mary has kidney cancer that has metastasized to her bones.
I do not have all the recent updates, but I remain hopeful for all of them.
There have been so many advances in cancer treatment within my lifetime. Some of these therapies were still theoretical when I first studied oncology over 25 years ago. Even my own treatment, PRRT, sounded like science fiction when I first read about it.
But all of these advancements still brings me back to what my professor said on the first day of lecture:
“Cure. Rarely anyone talks about cure.”
With the advancement in medical technologies, cure is now a reality for some. And I remain hopeful that my cousins will one day reach that point called NED: No Evidence of Disease.
For the past four years, with tremendous help from family and friends, my mission and vision in fundraising for research and support for people with rare cancers like mine: #pheochromocytoma and #paraganglioma has been tremendously successful.
With my health continuing to deteriorate, I made the decision for this year to be the Final Edition of JP’s Backyard Ultra and Hike. But I also intend to become more focused in making this rare #cancer not so rare anymore.
Paraganglioma occurs in only 2-6 people per million. That number may never change. But what I hope to change is awareness: more clinicians recognizing the disease, more guidance for those newly diagnosed, and more education reaching people globally.
That is how I intend for it to become not so rare anymore. This is how I will continue helping the small but tremendous group of people @pheopara the nonprofit beneficiary of JP’s Backyard Ultra and Hike.
Three more stories from the #thailand collection:
1. Last day in Koh Phi Phi where Monette and I had the beach to ourselves. We walked to the boats at low tide on our departure.
2. Bangla Road, the center of night life in Patong, where we had the most delicious seafood meal. Walked by the red light district and we were too tired to go into the bars.
3. Koh Samui at the Anantara Lawana Koh Samui Resort in Chaweng. White Lotus Season 3 fans would recognize this place.
Here’s another Thailand story among the many that is worth revisiting for me.
This experience was joyful. Bountiful fish but I do find the corals lacking. Still, I enjoyed it with a buoy. I would have swam during this trip if I could. But I know my limits. I get too short of breath and turn blue if I exert myself too much. Even pass out if my heart rate gets too high.
But knowing how to control my breathing and a bit of an assist from a pull buoy, can make a world of difference. That is to enjoy the sea again and its teeming wildlife. The baby sharks got scared off with too many people in the water. But we saw them. That’s a good sign for this place that was closed for six years by the Thai government to allow the beach, reef, and this breeding grounds for sharks to recover.
#khophiphileh
Some fun stories are worth a post. I thought most of the stories I saved I can revisit in the Thailand stories but I guess it was too many that it didn’t save.
Beaches here are fun with Monette. Beautiful indeed. But I have to agree with my Thai cousin Poppee: we both have been to pristine beaches in the Philippines.
I lived in Hawaii and pretty much learned to surf and swim in the ocean there. The recent trip in Bora Bora beaches was breathtaking.
But I am left longing for the beaches, the seas, of the Philippines, where my father taught me how to swim by simply asking me to jump off the bamboo raft we were on and commanded, “Langoy! (Swim!)”
I had no other choice.
#thailand
#kohphiphileh
We visited seven of these limestone karst islands in Phang Nga Bay. There’s about 42 of these islands in the bay according to the guide.
Some of the islands have nice white sand beaches where Monette and I lounged and then went swimming. Another one has a restaurant and shops on stilt foundations. They remind me of my fellow Filipinos from the southern Philippines, sea faring people, kind, soft spoken, kindred Muslim brothers and sisters.
I got another memento. A bracelet, similar to the bracelet I got from Bora Bora with pearls.
Some of these islands have caves. We went into one wearing hard hats, stooping low, and saw all the different colorations of the stones which could be different minerals. The cave led into a huge opening, that if the tide were higher, it would have been a lagoon.
My first experience seeing these rock formations were in El Nido, Palawan many years ago. Limestone karst islands can also be found in Vietnam in Ha Long Bay, and Indonesia.
After spending three days each on the west and east side of Phuket, we have now moved onto Ko Phi Phi for two nights. Relaxing mostly at the resort and a day of activity in Maya Bay snorkeling and lounging.
Gotta make time for chill vibes.
#thailand🇹🇭
