(Hunan – May 22, 2026) Pastor John Cao, a missionary who previously served a seven-year prison sentence in China, disclosed in a May 19 public prayer letter that he has been diagnosed with advanced prostate cancer. He asked supporters to pray for his recovery and for permission to return to the United States to reunite with his family.
In the letter, Cao said he sought treatment at Xiangya Hospital in Hunan after experiencing severe leg pain and insomnia for about a month. Because of heavy patient volume and limited consultation time, he said doctors initially diagnosed him with a leg sprain and inflammation.
More than two weeks later, an MRI examination revealed advanced tumors, delaying treatment, according to Cao.
John Cao said he lost about 11 pounds within a month, dropping to roughly 154 pounds. Doctors began androgen deprivation therapy and recently started chemotherapy, with six treatment cycles planned at 21-day intervals. Physicians said they will monitor his ability to tolerate the treatment because of its effects on the immune system and healthy cells.
Doctors initially scheduled surgery to remove the spinal tumors for April 29 but canceled the procedure because of surgical risks, Cao said. Physicians now plan to pursue radiation therapy instead.
Cao, who holds U.S. permanent residency, spent more than a decade conducting missionary and humanitarian work along the China-Myanmar border, including operating schools and assisting impoverished children.
Chinese authorities arrested him in 2017 after he crossed the border outside official checkpoints while returning from relief work in Myanmar’s Wa region along the Chinese border. He was later convicted of “organizing illegal border crossings” and sentenced to seven years in prison.
Although released in March 2024, Cao says he has been unable to obtain documents needed to leave China.
Cao said he has formally applied to government authorities for permission to return to the United States. Local officials reportedly told him the request has been forwarded to higher authorities for approval, with the final decision pending in Beijing.
He also expressed gratitude for assistance provided by local government departments in Changsha, the capital of Hunan Province, during his illness.
Cao’s wife, eldest son and his son’s fiancée traveled from the United States to Changsha on April 25 and stayed with him for 10 days before returning because of work obligations. He now lives with his elderly mother in Changsha, while members of a local church rotate meal deliveries and a younger church member assists with daily care.
Concluding the prayer letter, Cao quoted Psalm 129 to express confidence in God’s faithfulness despite suffering. He asked churches and supporters inside and outside China to pray both for healing from cancer and for approval to return to the United States to reunite with his family after years of separation.
Gao Zhensai is a special correspondent for ChinaAid News. Founded in 2002, ChinaAid is an international, Christian nonprofit human rights organization that inspires, informs, and invites people to transformative action on behalf of persecuted people of all faiths in China.