Angel Cruzado

It is Day 350 living with cancer, and wrestling with a question I never imagined asking: How do you remain relevant when so many fighting the same disease are no longer here? Pancreatic cancer is unforgiving given that survival is often measured in months. Many who began this journey with me are gone. Their absence reminds me that every day is both a privilege and an uncertainty. Surviving becomes more complicated than staying alive. How do you remain ambitious and connected to a world that sometimes seems to be preparing for your departure? For me, relevance begins with writing daily. These reflections help me make sense of a disease that has changed my body, priorities and relationship with time. They remind me that I still have something to contribute. I am a Dad, Founder and am building Respiris, a company focused on helping people rediscover confidence and dignity during career transitions. Respiris is not yet profitable in the traditional sense, but it delivers something extraordinarily valuable to me: purpose. Every displaced employee we support and every coach we recruit reminds me that my work matters. There is something reciprocal about helping people navigate professional loss while I navigate the possibility of losing my own life. Their transitions give me perspective on mine. Building a company requires planning, discipline and the belief that tomorrow is worth investing in. Cancer demands the same intensity. The strange thing is that planning for a future I cannot count on is precisely what keeps me invested in the present. My latest imaging suggests that my tumors on the left side of my liver are growing while the right liver tumors remains stable I have pivoted from chemo to an investigational treatment, RMC-5127, targeting my KRAS G12V mutation, and built by Revolution Medicines. I hope it produces a meaningful response in both my pancreatic cancer and the tumors in my liver. There are no guarantees, but this pivot feels increasingly important. I can be excited about being a Daddy, building a company and a clinical trial while confronting the possibility that treatment may not work. Those emotions coexist and neither cancels out the other. One of the hardest parts of advanced cancer is convincing people to see the person beyond the diagnosis. Some see a cancer patient and immediately see mortality. They become uncomfortable with your ambition, optimism or plans for tomorrow, but I am not living every day as though it is my last. I am living every day as though my future still deserves my attention. I will raise my daughter, build a meaningful company and help people rediscover their potential. Taking my cancer seriously does not mean treating me as though I am already gone. Perhaps relevance is not about how long we remain here, but how deeply we participate in life while we are here. Thank you for reading, for being here and for allowing me to be part of your journey as you become part of mine.

It is Day 345 living with cancer, and fighting to live is tiring. Earlier this week, I was offered a slot in a clinical trial. I feel enormous gratitude, but getting to this point took more out of me than I realized. There is the physical part: chemo two weeks on and one week off. There is the aftermath, when your body simply stops working the way it is supposed to work. Then there is the mental part, when you desperately want one ordinary day without thinking about your mortality. Cancer gives you both a curse and a gift: a life shot clock that constantly reminds you that you are human. The exhaustion comes from carrying all of those things at once while continually preparing for an unknown future. Now comes a third medical center, a clinical trial, a new city, new oncology staff, unfamiliar language about cycles and treatment schedules, and a targeted therapy aimed directly at my cancer. It feels a little like starting a new job and onboarding yourself from scratch, except the job is to stay alive. Along this journey, people have told me about loved ones who were diagnosed around the same time I was diagnosed and who are no longer here. I hear those stories and carry them… from Patrick Swayze to Steve Jobs to RGB to Randy Pausch to people recently diagnosed with cancer. I simply refuse to concede to cancer. I have not shared that I tend to walk into infusion centers and medical centers alone. There is something important to me about making my own decisions, listening carefully to what my body is telling me, studying the signals I am receiving, and paying equal attention to the signals I am not receiving. Because I sometimes wonder, if I concede an inch, will I eventually concede a foot? And if I concede a foot, will I someday concede a mile? So I keep moving. Today my body hurts. Southern California feels unreasonably hot in October at nearly 105 degrees. Yet I drove 20 minutes for a cup of coffee that I plan to enjoy slowly for at least an hour. On the days when I do not have Iris with me, I am alone, my mind can spin, but I reflect, calculate, worry, plan and proactively search for the next opening. Cancer is no joke. In less than a year, my body has moved from roughly 180 pounds to 125 pounds and back to around 165 pounds. Some days I look in the mirror and genuinely wonder what exactly is happening inside me. I am grateful, yet exhausted, but equally hopeful. Psalm 23:4 says, “Though I walk through the valley of the shadow of death, I will fear no evil.” The important word for me today is “walk.” The verse does not say we understand the valley. It does not promise that the valley will be painless. It simply reminds me that the valley is something we move through. So that is what I am doing… walking. Sometimes confidently, other times painfully with absolutely no idea where the path leads. Thank you for the prayers, good vibes, thoughts and financial support via GoFundMe to alleviate travel expenses.

It is Day 344 living with cancer, and after a mostly sleepless night, I finally worked backward through what the next month could look like. The RMC-5127 clinical trial is no longer an abstract possibility. It now has dates, travel, blood draws, screening, long days in Sacramento and a tentative treatment start. The biggest decision in front of me is whether I receive my 27th Gem/Abraxane infusion next week. The trial requires at least a 21-day chemo washout before RMC-5127. Technically, I could receive chemo on October 7 and still satisfy that requirement before the planned October 29 start. But after 26 infusions, my body and mind is asking for something different. Rest. If my oncology and clinical-trial teams agree, I am considering skipping that final infusion and giving my body roughly 30 days without chemo before this next chapter begins. Yes, 30 entire days without chemo! 30 days for my blood counts to recover. 30 day without Gem/Abraxane beating up my body. And, 30 days to eat, sleep, move and hopefully regain some emotional and physical strength before asking my body to learn an entirely new medication in a whole new city. Then the real work begins. October 12 starts the formal UC Davis screening process. October 26 is C1D-3, potentially a 14-hour day of labs, EKGs and repeated blood draws as researchers study how RMC-5127 moves through my body. October 29 is the anchor: Cycle 1, Day 1. Then November brings more monitoring, labs and another intensive pharmacokinetic day as the team learns not only whether the drug is reaching its target, but how my body is tolerating it. I will need to figure out Sacramento. Do I drive the first time so I can understand the city landscape and get the lay of the land? Do I eventually fly? Where do I stay? How do I coordinate all of this around being a Dad, school events, work and the ordinary pieces of life that cancer does not get to cancel? That is the strange rhythm of stage iv cancer pancreatic cancer. This morning, I was re-calculating chemo washout periods, clinical-trial cycles, Sacramento, Houston and Austin travel. I will eventually have to close the google sheet and go work the school carnival booth fundraiser for my 10:00 a.m. shift. Somewhere between these two worlds of being a Dad and having a terminal cancer is my life. I was officially diagnosed with pancreatic cancer October 22, 2025 and, for almost a year, I have asked this body to fight like my life depended on it. I am quite proud of myself in continuing to succeed in being a founder building with cancer. Did I tell you that Respiris succeeded in signing up a company with a 1 trillion market cap? It is only one candidate in transition, but it is a start of a new partner relationship. Maybe the next part of this fight begins by celebrating the fact that made it out alive one year, celebrating life, and to give myself a little latitude to recover before asking it to fight differently.

It is Day 342 living with cancer, and today one of the dots connected. I am incredibly happy to share that I have been accepted into the RMC-5127 clinical trial. After months of searching across the country, calling medical centers, sending records, asking questions and refusing to stop looking, I finally have access to a phase 1 investigational treatment designed to directly target KRAS G12V, the mutation driving my pancreatic cancer. This feels H U G E. Steve Jobs, who also faced pancreatic cancer, told Stanford graduates in a 2005 commencement speech that you cannot connect the dots looking forward; you can only connect them looking backward. Somehow, you have to trust that they will connect. I understand those words differently now. A year ago, I returned from Puerto Rico after seeing Bad Bunny with my brother. 3 weeks later I learned that I had stage iv pancreatic cancer. Since then, I have spent 342 days learning how to be a cancer patient with a 5 year survival rate of 13%. I did not abandon Respiris, but my survival required my attention to move elsewhere. I had to understand chemo, scans, tumor markers, labs, enzymes, insurance, second opinions, clinical trials and a medical vocabulary I never wanted to learn. I also had to rely on capabilities I spent decades developing without imagining I would ever need them for this. This cancer has required me to step outside my comfort zone and push others outside theirs. I have asked uncomfortable questions, chatted with strangers and built communities with family, friends, internet, and medical centers. All up, researchers, physicians, nurses, cancer patients and strangers have come together to help me stay alive. The vibes, prayers and GoFundMe are working. Iris and I have shared our journey with the City of Hope community to help raise money. At the same time, we changed school districts, moved into a new home, and tried to preserve an ordinary life while pancreatic cancer kept rearranging ours. We searched trials in Texas, Virginia, Michigan, Massachusetts, Connecticut and now Northern California. RMC-5127 is not a promise, and experimental treatment comes with no guarantees, but when you are living with stage iv pancreatic cancer, another scientifically credible option can feel like oxygen. So, yes, let us celebrate this one. I am relieved, nervous, ecstatic, and hopeful. And now I have to figure out Sacramento flights, hotels, treatment schedules, parenting, Respiris, insurance, logistics and my body. Maybe this is what connecting the dots actually looks like in my life. You keep moving even when you cannot see the whole picture. You keep asking, sharing and knocking, even after doors close. Because sometimes faith is simply believing that one door will eventually open. I still do not know how all the dots will connect. I only know that I kept moving long enough to reach the next one. I got the slot. And now, I am getting on the plane.

It is technically Day 341 living with cancer, and at 2:30 a.m. I need to clear my mind because there are so many moving parts in my Sleepless in Seattle brain. After reaching out to more than 10 medical centers by email and phone, I may have secured a slot for the RMC-5127 clinical trial in Northern California. Once again, I have to thank my AI oncologist, Sapo Concho, for alerting me Monday that another medical center was running the trial. Let me explain why this matters. When you have a terminal illness, treatment starts to feel like a war fought through successive lines of defense. NALIRIFOX was my front line. It attacked 1st and gave me runway, but eventually my CT scan and MRI showed that the cancer was growing. We needed reinforcements. That brought us to Gemcitabine and Abraxane. We started with 3 weeks on and 1 week off, then moved to 2 weeks on and 1 week off. Given the GI side effects and cumulative toll, we may eventually move toward 1 week on and 1 week off. Even the strongest battleship has to return to port. My body needs rest. I can feel these treatments in nearly every inch of me, which is why I am doubling down on acupuncture, recovery, nutrition, and anything that helps me keep fighting. At the same time, I am thinking several moves ahead. RASONQUE, formerly known as Daraxonrasib, represents my last line of defense, but before I push that red button, I want to understand whether there is another line of defense. That is where RMC-5127 enters the picture. If I qualify, perhaps that line of defense can shrink, control, or neutralize this tumor and give me what I value most right now. Life runway. Runway to keep building Respiris into something larger than me and scale a methodology rooted in empathy, identity, purpose, family, community, and the belief that nobody should navigate a major transition alone. Most importantly, I want more runway to raise Iris. She is a bright 6th grade human whose grandparents did not finish high school and whose Dad became the only one of 4 brothers to complete undergrad and grad school. I want to see where gymnastics, rowing, theater, school, friendships, curiosity, and life take her. I want enough time to help my kid learn how to fly. Because, as Wicked reminds us, “Everyone deserves the chance to fly.” Maybe that is why Defying Gravity keeps playing in my head tonight. There comes a moment when second-guessing stops helping. You make the calls, send the emails, ask for help, study the options, listen to your body, and accept that nobody can promise what happens next. Then you trust your instincts, close your eyes, and take the leap. Cancer has introduced gravity into nearly every part of my life, but gravity does not get the final word. So tonight, with clinical trials, chemo, Respiris, Dad, fear, hope, and trains moving through Grand Central Station inside my head, I know what comes next. Keep fighting, building, parenting, loving, and keep trying to defy gravity.

It is Day 336 living with cancer and I sometimes think of chemo like stepping into a boxing ring. The cancer is the opponent I am trying to hit, but my body is standing in the same ring. Every infusion throws another combination of punches at the cancer, while my nerves, bone marrow, muscles, digestive system, immune system and hair follicles absorb some of the blows too. After 26 infusions, I do not look or feel like the same guy who walked into Round 1. My eyebrows and eyelashes are gone. I cannot grow a beard. Food develops that unmistakable chemo taste. Neuropathy has settled into my toes and fingers. Bone pain is quite real. Fatigue makes the simplest responsibility feel like I am carrying a backpack filled with bricks. There are days when my body feels like it has fought 26 rounds because, in many ways, it has. But there is another side to those 26 rounds. Every infusion is an opportunity to slow the cancer, push it backward, protect my organs and buy more time. Time means being a Dad to a kid who deeply loves her Dad and a Dad who loves her back. It means another gymnastics practice, another school pickup, another birthday, another ridiculous conversation with Iris in the car about “Crew Girl.” But mostly, it is another opportunity to watch her grow into the person she is becoming. When I got cancer, I was learning how to be a Founder. Founders learn to operate when there is no perfect roadmap. We make decisions with incomplete information, manage limited resources, change strategy when something stops working, find people who know more than we do and keep building toward a future we cannot completely see. Cancer has forced me to become the Founder of my own survival strategy. I study the science, ask questions, contact physicians, look for clinical trials, and pursue second opinions. I think about the next treatment before I necessarily need it because waiting until the runway disappears is not a strategy I am comfortable with. Cancer is expensive in ways people do not always see. Treatment, insurance, medications, travel, second opinions, clinical trials and simply trying to create meaningful experiences with Iris continue to eat into our budget as we try to go the distance. That is why I remain deeply grateful for every prayer, every good vibe, every ounce of positive energy and every contribution to our GoFundMe. None of it feels small from this side of the ring. A message can arrive on the exact day I need encouragement. A contribution can help fund another trip, appointment or opportunity. Someone sharing my story can create a connection I never knew I needed. So I keep walking back into the ring, not because I enjoy fighting… I walk back in the ring everyday because I am a Dad who wants more time with Iris, a Founder who has things to build, and a human who deeply wants to stay alive long enough to see what science discovers next and enough time to move Iris into her college dorm.

It is Day 335 living with cancer, and yesterday was rough in a way that felt heavier than the usual chemo day. Maybe some of that weight came from getting closer to the 12 months since my official diagnosis, or maybe my body simply understands the impact of 26 infusions. The evidence is now hard to miss. I have no eyebrows, my eyelashes are gone and I can no longer grow a beard. Cancer has changed my face so much that I have had to reset Face ID on my iPhone twice. Apparently, even Apple needs time to adjust. There is humor in that, but there is also something hard about watching my face change while knowing that the treatment causing those changes is also helping keep me alive. Chemo does not end when the infusion pump stops. Yesterday, the bone pain came quickly. Fatigue settled deep into my body. Food had that awful chemo taste, my energy disappeared without warning, and even ordinary tasks felt enormous. A trip to the grocery store can feel like running a marathon when your body is already running one of its own. But yesterday was not only hard, it had its bright spots. School pickup was beautiful. Taking Iris to horseback riding felt wonderfully normal. Catching up with a friend gave me energy that medicine cannot provide. That is one of the strange things about cancer. Mortality is exhausting company, but it also makes ordinary moments feel extraordinary. People who follow this journey know that I refuse to concede my life to cancer. I continue pursuing science, treatments and clinical trials while spending my time being a Dad, building Respiris and helping people through their own transitions. But refusing to concede does not mean pretending I am invincible. Yesterday reminded me that strength can look much quieter than fighting. Sometimes it means admitting that my bones hurt, my body is exhausted and chemo has emptied the tank, then giving myself space to recover without confusing rest with surrender. There is a difference between giving up and giving yourself space. I am figuring out that resilience is not pretending to be positive every day. Real resilience makes room for pain, fear, exhaustion, gratitude, humor and hope. Cancer may shape some of the conditions of my life, but it does not get to decide how fully I live it. So today, I move forward again, maybe more slowly and certainly more gently.

It is Day 334 living with cancer, and by the time much of my LinkedIn community settles into an office, opens a laptop from home, or begins scrolling through the morning feed, I will have completed my 26th infusion. I am writing this at the evening of another sleepless night, waiting for numbers that have somehow become capable of changing the emotional temperature of an entire day. CA 19-9. CA-125. CEA. Poetically, I want those three tubes of blood to tell me whether the cancer has grown, stayed the same, or retreated. Before any of that comes the machinery of being a patient begins: Name. Date of birth. Insurance. PICC line? Have you fallen? Is anyone at home trying to hurt you? Any new symptoms? Has anything changed? Temperature. Weight. Blood pressure. Then the tubes. One for tumor markers. One for the comprehensive metabolic panel (cmp). One for the complete blood count (cbc) and differential. You learn quickly that nearly everything you say becomes part of your medical record. Fall once and that little fact can follow you around with greater loyalty than some former colleagues. There is also the human choreography of cancer care: front-line workers making small talk, nurses asking how you are feeling, people trying to make an abnormal morning feel almost normal. I will smile, engage, probably crack a joke. Them: “how are you today?” Me: “living the dream… (pause) with cancer.” But what I am really thinking about at 5:00 a.m. is 3:45 p.m. That is when I get to pick up Iris from the school car line, hear how choir is going, and drive her to therapeutic horseback riding at 4:00. While she rides, I will try to move my own body, even if this chemo-beaten version of it hurts like hell. I hope I will remember to remove the hospital wristband hanging from my arm like I accidentally spent the morning at Coachella. We may order dinner. And when I eat, I will not to complain about the metallic chemotherapy taste because my 26th infusion does not need to become the centerpiece of Iris’s evening. She will remind me, however, to take Creon. My face looks bonier lately. My eyebrows are gone. Edema has thickened my arms and legs while low protein has become another thing to manage. Cancer has a way of making the body simultaneously smaller and heavier. Most of us will over-index on work. We will come to LinkedIn to learn, sell, recruit, lead and offer color commentary on professional life. Meanwhile, millions of people are carrying entire private worlds into those same meetings. Today, mine happens to include three tubes of blood, infusion number 26, a school pickup line, a horse, a daughter, and the hope that somewhere inside those lab results is evidence that I get more time. And for today, more time is enough. Many of my pancreatic cancer patient colleagues don’t make it to 334 days living with cancer. I will see new patient faces and their family members supporting them and hope that they too get more time.