Five months after the Suffering and the Sovereignty of God conference, two of the speakers—John Piper and David Powlison—were diagnosed with prostate cancer. On the eve of his prostate surgery (February 13, 2006) John Piper wrote the following article in reflection on his situation and in order to minister grace and truth to others. (It should be noted that this is one way to minister pastorally to those in need, but it’s not the only way to do so and it is not the only thing that needs to be said.) David Powlison then added the reflections italicized below on the morning after receiving the news that he had been diagnosed with prostate cancer (March 3, 2006).
I believe in God’s power to heal—by miracle and by medicine. I believe it is right and good to pray for both kinds of healing. Cancer is not wasted when it is healed by God. He gets the glory and that is why cancer exists. So not to pray for healing may waste your cancer. But healing is not God’s plan for everyone. And there are many other ways to waste your cancer. I am praying for myself and for you that we will not waste this pain.
- You will waste your cancer if you do not believe it is designed for you by God.
- You will waste your cancer if you believe it is a curse and not a gift.
- You will waste your cancer if you seek comfort from your odds rather than from God.
- You will waste your cancer if you refuse to think about death.
- You will waste your cancer if you think that “beating” cancer means staying alive rather than cherishing Christ.
- You will waste your cancer if you spend too much time reading about cancer and not enough time reading about God.
- You will waste your cancer if you let it drive you into solitude instead of deepen your relationships with manifest affection.
- You will waste your cancer if you grieve as those who have no hope.
- You will waste your cancer if you treat sin as casually as before.
- You will waste your cancer if you fail to use it as a means of witness to the truth and glory of Christ.
It will not do to say that God only uses our cancer but does not design it. Not that his first design for creation was a Garden of Eden with cancer. But the fall did not take God off guard. He was planning redemption before creation (2 Timothy 1:9). He saw it coming and permitted it. What God permits, he permits for a reason. And that reason is his design. If God foresees molecular developments becoming cancer, he can stop it or not. If he does not, he has a purpose. Since he is infinitely wise, it is right to call this purpose a design. Satan is real and causes many pleasures and pains. But he is not ultimate. So when he strikes Job with boils (Job 2:7), Job attributes it ultimately to God (2:10) and the inspired writer agrees: “They . . . comforted him for all the evil that the LORD had brought upon him” (Job 42:11). If you don’t believe your cancer is designed for you by God, you will waste it.
Recognizing his designing hand does not make you stoic or dishonest or artificially buoyant. Instead, the reality of God’s design elicits and channels your honest outcry to your one true Savior. God’s design invites honest speech, rather than silencing us into resignation. Consider the honesty of the Psalms, of King Hezekiah (Isaiah 38), of Habakkuk 3. These people are bluntly, believingly honest because they know that God is God and set their hopes in him. Psalm 28 teaches you passionate, direct prayer to God. He must hear you. He will hear you. He will continue to work in you and your situation. This outcry comes from your sense of need for help (28:1-2). Then name your particular troubles to God (28:3-5). You are free to personalize with your own particulars. Often in life’s ‘various trials’ (James 1:2), what you face does not exactly map onto the particulars that David or Jesus faced—but the dynamic of faith is the same. Having cast your cares on him who cares for you, then voice your joy (28:6-7): the God-given peace that is beyond understanding. Finally, because faith always works out into love, your personal need and joy will branch out into loving concern for others (28:8-9). Illness can sharpen your awareness of how thoroughly God has already and always been at work in every detail of your life.
“There is therefore now no condemnation for those who are in Christ Jesus” (Rom. 8:1). “Christ redeemed us from the curse of the law by becoming a curse for us” (Gal. 3:13). “There is no enchantment against Jacob, no divination against Israel” (Num. 23:23). “The LORD God is a sun and shield; the LORD bestows favor and honor. No good thing does he withhold from those who walk uprightly” (Ps. 84:11).
The blessing comes in what God does for us, with us, through us. He brings his great and merciful redemption onto the stage of the curse. Your cancer, in itself, is one of those 10,000 “shadows of death” (Ps. 23:4) that come upon each of us: all the threats, losses, pains, incompletion, disappointment, evils. But in his beloved children, our Father works a most kind good through our most grievous losses: sometimes healing and restoring the body (temporarily, until the resurrection of the dead to eternal life), always sustaining and teaching us that we might know and love him more simply. In the testing ground of evils, your faith becomes deep and real, and your love becomes purposeful and wise (James 1:2-5; 1 Pet. 1:3-9; Rom. 5:1-5; Rom. 8:18-39).
The design of God in your cancer is not to train you in the rationalistic, human calculation of odds. The world gets comfort from their odds. Not Christians. Some count their chariots (percentages of survival), and some count their horses (side effects of treatment), but we trust in the name of the Lord our God (Ps. 20:7). God’s design is clear from 2 Corinthians 1:9, “We felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead.” The aim of God in our cancer (among a thousand other good things) is to knock props out from under our hearts so that we rely utterly on him.
God himself is your comfort. He gives himself. The hymn “Be Still My Soul” (by Katerina von Schlegel) reckons the odds the right way: we are 100% certain to suffer, and Christ is 100% certain to meet us, to come for us, comfort us, and restore love’s purest joys. The hymn “How Firm a Foundation” reckons the odds the same way: you are 100% certain to pass through grave distresses, and your Savior is 100% certain to “be with you, your troubles to bless, and sanctify to you your deepest distress.” With God, you aren’t playing percentages, but living within certainties.
We will all die, if Jesus postpones his return. Not to think about what it will be like to leave this life and meet God is folly. Ecclesiastes 7:2 says, “It is better to go to the house of mourning [a funeral] than to go to the house of feasting, for this is the end of all mankind, and the living will lay it to heart.” How can you lay it to heart if you won’t think about it? Psalm 90:12 says, “Teach us to number our days that we may get a heart of wisdom.” Numbering your days means thinking about how few there are and that they will end. How will you get a heart of wisdom if you refuse to think about this? What a waste, if we do not think about death.
Paul describes the Holy Spirit as the unseen, inner “downpayment” on the certainty of life. By faith, the Lord gives a sweet taste of the face-to-face reality of eternal life in the presence of our God and Christ. We might also say that cancer is one “downpayment” on inevitable death, giving one bad taste of the reality of our mortality. Cancer is a signpost pointing to something far bigger: the last enemy that you must face. But Christ has defeated this last enemy (1 Corinthians 15). Death is swallowed up in victory. Cancer is merely one of the enemy’s scouting parties, out on patrol. It has no final power if you are a child of the resurrection, so you can look it in the eye.
Satan’s and God’s designs in your cancer are not the same. Satan designs to destroy your love for Christ. God designs to deepen your love for Christ. Cancer does not win if you die. It wins if you fail to cherish Christ. God’s design is to wean you off the breast of the world and feast you on the sufficiency of Christ. It is meant to help you say and feel, “I count everything as loss because of the surpassing worth of knowing Christ Jesus my Lord.” And to know that therefore, “To live is Christ, and to die is gain” (Phil. 3:8; 1:21).
Cherishing Christ expresses the two core activities of faith: dire need and utter joy. Many psalms cry out in a “minor key”: we cherish our Savior by needing him to save us from real troubles, real sins, real sufferings, real anguish. Many psalms sing out in a “major key”: we cherish our Savior by delighting in him, loving him, thanking him for all his benefits to us, rejoicing that his salvation is the weightiest thing in the world and that he gets last say. And many psalms start out in one key and end up in the other. Cherishing Christ is not monochromatic; you live the whole spectrum of human experience with him. To “beat” cancer is to live knowing how your Father has compassion on his beloved child, because he knows your frame, that you are but dust. Jesus Christ is the way, the truth, and the life. To live is to know him, whom to know is to love.
It is not wrong to know about cancer. Ignorance is not a virtue. But the lure to know more and more and the lack of zeal to know God more and more is symptomatic of unbelief. Cancer is meant to waken us to the reality of God. It is meant to put feeling and force behind the command, “Let us know; let us press on to know the LORD” (Hos. 6:3). It is meant to waken us to the truth of Daniel 11:32, “The people who know their God shall stand firm and take action.” It is meant to make unshakable, indestructible oak trees out of us: “His delight is in the law of the LORD, and on his law he meditates day and night. He is like a tree planted by streams of water that yields its fruit in its season, and its leaf does not wither. In all that he does, he prospers” (Ps. 1:2-3). What a waste of cancer if we read day and night about cancer and not about God.
What is so for your reading is also true for your conversations with others. Other people will often express their care and concern by inquiring about your health. That’s good, but the conversation easily gets stuck there. So tell them openly about your sickness, seeking their prayers and counsel, but then change the direction of the conversation by telling them what your God is doing to faithfully sustain you with 10,000 mercies. Robert Murray McCheyne wisely said, “For every one look at your sins, take ten looks at Christ.” He was countering our tendency to reverse that 10:1 ratio by brooding over our failings and forgetting the Lord of mercy. What McCheyne says about our sins we can also apply to our sufferings. For every one sentence you say to others about your cancer, say ten sentences about your God, and your hope, and what he is teaching you, and the small blessings of each day. For every hour you spend researching or discussing your cancer, spend 10 hours researching and discussing and serving your Lord. Relate all that you are learning about cancer back to him and his purposes, and you won’t become obsessed.
When Epaphroditus brought the gifts to Paul sent by the Philippian church he became ill and almost died. Paul tells the Philippians, “He has been longing for you all and has been distressed because you heard that he was ill” (Phil. 2:26-27). What an amazing response! It does not say they were distressed that he was ill, but that he was distressed because they heard he was ill. That is the kind of heart God is aiming to create with cancer: a deeply affectionate, caring heart for people. Don’t waste your cancer by retreating into yourself.
Our culture is terrified of facing death. It is obsessed with medicine. It idolizes youth, health, and energy. It tries to hide any signs of weakness or imperfection. You will bring huge blessing to others by living openly, believingly, and lovingly within your weaknesses. Paradoxically, moving out into relationships when you are hurting and weak will actually strengthen others. “One anothering” is a two-way street of generous giving and grateful receiving. Your need gives others an opportunity to love. And since love is always God’s highest purpose in you, too, you will learn his finest and most joyous lessons as you find small ways to express concern for others even when you are most weak. A great, life-threatening weakness can prove amazingly freeing. Nothing is left for you to do except to be loved by God and others, and to love God and others.
Paul used this phrase in relation to those whose loved ones had died: “We do not want you to be uninformed, brothers, about those who are asleep, that you may not grieve as others do who have no hope” (1 Thess. 4:13). There is a grief at death. Even for the believer who dies, there is temporary loss—loss of body, and loss of loved ones here, and loss of earthly ministry. But the grief is different—it is permeated with hope. “We would rather be away from the body and at home with the Lord” (2 Cor. 5:8). Don’t waste your cancer grieving as those who don’t have this hope.
Show the world this different way of grieving. Paul said that he would have had “grief upon grief” if his friend Epaphroditus had died (Phil. 2:27). He had been grieving, feeling the painful weight of his friend’s illness. He would have doubly grieved if his friend had died. But this loving, honest, God-oriented grief coexisted with “rejoice always” and “the peace of God that passes understanding” and “showing a genuine concern for your welfare” (Phil. 4:4, 7; 2:20). How on earth can heartache coexist with love, joy, peace, and an indestructible sense of life purpose? In the inner logic of faith, this makes perfect sense. In fact, because you have hope, you may feel the sufferings of this life more keenly: grief upon grief. In contrast, the grieving that has no hope often chooses denial or escape or busyness because it can’t face reality without becoming distraught. In Christ, you know what’s at stake, and so you keenly feel the wrong of this fallen world. You don’t take pain and death for granted. You love what is good, and hate what is evil. After all, you follow in the image of “a man of sorrows, acquainted with grief” (Isa. 53:3). But this Jesus chose his cross willingly “for the joy set before him” (Heb. 12:2). He lived and died in hopes that all come true. His pain was not muted by denial or medication, nor was it tainted with despair, fear, or thrashing about for any straw of hope that might change his circumstances. Jesus’ final promises overflow with the gladness of solid hope amid sorrows: “My joy will be in you, and your joy will be made full. Your grief will be turned to joy. No one will take your joy away from you. Ask, and you will receive, so that your joy will be made full. These things I speak in the world, so that they may have my joy made full in themselves” (selection from John 15-17).
Are your besetting sins as attractive as they were before you had cancer? If so, you are wasting your cancer. Cancer is designed to destroy the appetite for sin. Pride, greed, lust, hatred, unforgiveness, impatience, laziness, procrastination—all these are the adversaries that cancer is meant to attack. Don’t just think of battling against cancer. Also think of battling with cancer. All these things are worse enemies than cancer. Don’t waste the power of cancer to crush these foes. Let the presence of eternity make the sins of time look as futile as they really are. “What does it profit a man if he gains the whole world and loses or forfeits himself?” (Luke 9:25).
Suffering really is meant to wean you from sin and strengthen your faith. If you are God-less, then suffering magnifies sin. Will you become more bitter, despairing, addictive, fearful, frenzied, avoidant, sentimental, godless in how you go about life? Will you pretend its business as usual? Will you come to terms with death, on your terms? But if you are God’s, then suffering in Christ’s hands will change you, always slowly, sometimes quickly. You come to terms with life and death on his terms. He will gentle you, purify you, cleanse you of vanities. He will make you need him and love him. He rearranges your priorities, so first things come first more often. He will walk with you. Of course you’ll fail at times, perhaps seized by irritability or brooding, escapism or fears. But he will always pick you up when you stumble. Your inner enemy—a moral cancer 10,000 times more deadly than your physical cancer—will be dying as you continue seeking and finding your Savior: “For your name’s sake, O LORD, pardon my iniquity, for it is very great. Who is the man who fears the LORD? He will instruct him in the way he should choose” (Psalm 25).
Christians are never anywhere by divine accident. There are reasons for why we wind up where we do. Consider what Jesus said about painful, unplanned circumstances: “They will lay their hands on you and persecute you, delivering you up to the synagogues and prisons, and you will be brought before kings and governors for my name’s sake. This will be your opportunity to bear witness” (Luke 21:12-13). So it is with cancer. This will be an opportunity to bear witness. Christ is infinitely worthy. Here is a golden opportunity to show that he is worth more than life. Don’t waste it.
Jesus is your life. He is the man before whom every knee will bow. He has defeated death once for all. He will finish what he has begun. Let your light so shine as you live in him, by him, through him, for him. One of the church’s ancient hymns puts it this way:
Christ be with me, Christ within me,
Christ behind me, Christ before me,
Christ beside me, Christ to win me,
Christ to comfort and restore me.
Christ beneath me, Christ above me,
Christ in quiet, Christ in danger,
Christ in hearts of all that love me,
Christ in mouth of friend and stranger.1
In your cancer, you will need your brothers and sisters to witness to the truth and glory of Christ, to walk with you, to live out their faith beside you, to love you. And you can do same with them and with all others, becoming the heart that loves with the love of Christ, the mouth filled with hope to both friends and strangers.
Remember you are not left alone. You will have the help you need. “My God will supply every need of yours according to his riches in glory in Christ Jesus” (Phil. 4:19).
Cecil F. Alexander, “I Bind unto Myself Today” (1889).
John Piper is Pastor for Preaching & Vision, at Bethlehem Baptist Church, Minneapolis, Minnesota.
David Powlison is a faculty member at CCEF and has been counseling for over thirty years.
This article appeared in The Journal of Biblical Counseling, Spring 2006 issue (Volume 24, Number 2).
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