Man with terminal cancer diagnosis completes Ironman World Championship

A man who was diagnosed with terminal cancer recently fulfilled his longtime dream and defied the odds by completing the VinFast Ironman World Championship, one of the most challenging sporting events in the world.

Jonathan Pascual, a 50-year-old lung transplant nurse practitioner from Vallejo, California, earned Legacy Athlete status and qualified for the World Championship last weekend after completing over 15 Ironman triathlons throughout his life.

An Ironman event involves a 2.4-mile swim, a 112-mile bike ride and finishes with a marathon 26.2-mile run. The Ironman World Championship is the top event in this series.

In 2022, Pascual was diagnosed with Stage 4 mediastinal paraganglioma, a rare form of cancer that spread to his lungs and bones, leaving him with a five-year survival estimate, according to his doctor. He was previously diagnosed with a brain tumor in 2007 but was able to have it surgically removed.

Pascual, who had taken part in Ironman triathlons since 1999, told "Good Morning America" it was "definitely harder to train" for the World Championship in October due to his symptoms, which include shortness of breath and chronic pain.

"If I run too fast or too hard, my heart rate will go sky high and I will get dizzy and even faint," he said.

According to the National Cancer Institute, paraganglioma "is a type of neuroendocrine tumor that forms near certain blood vessels and nerves outside of the adrenal glands."

"Paraganglioma is rare and it is estimated that only 2 people out of every 1 million people have paraganglioma. It is most often found in people aged 30 to 50 years old," the agency states.

While paragangliomas are rare and may occur in many places throughout the body, "mediastinal paragangliomas are even rarer ... accounting for less than 0.3% of mediastinal masses," according to research published in the journal Medicine (Baltimore), available in the National Library of Medicine.

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According StatPearls, an online library published in the National Library of Medicine, the mediastinum "is a central compartment in the thoracic cavity between the pleural sacs of the lungs."

For Pascual, the toughest part of the event was the 2.4-mile swim. He explained that the tumor affected blood flow from being in a prone position, causing severe breathing difficulties.

"There were times that I had to flip over my back just to catch my breath," he recalled.

He noted that his participation in the Ironman championship represents not just a personal achievement but also a tribute to other cancer patients, later adding that getting to the finish line was a moment he had long envisioned, saying, "I have played [it] in my mind [like] a movie for so long."

Drawing from his journey, Pascual offered advice for those facing their own difficulties, encouraging them to "never be afraid to ask for help" and adding that he is where he is today because of the support he received.

He said he also likes to remind people about the significance of being a good influence on others.

"It is very important that you are able to be a good friend, the best teammate, the best son or daughter and be the kindest person in the room," he said. "Be a force for good so that you can affect other people's lives."