Diary of a Terminal Cancer Patient

Have you ever kept a diary? Many of us have started one—or at least thought about it—and some have been faithful to record their thoughts and feelings over time. Whether you’ve ever written in a diary or not, diaries have changed: many are now stored in the cloud, and some can even be created with the help of artificial intelligence. Musely.ai describes its AI-backed diary platform this way:

“AI Personal Diaries Generator: Transform Your Daily Thoughts - Turn your everyday experiences into beautifully written diary entries with our AI-powered diary generator. Simply input your thoughts or daily events, and let our intelligent system craft personalized, reflective journal entries that capture your authentic voice.

Merriam-webster defines “diary” as follows: a record of events, transactions, or observations kept daily or at frequent intervals.  The definition goes on to say it is a journal or a daily record of personal activities, reflections, or feelings.

I lead a Cancer Support Group (“CSG”) at my church, and from time-to-time people from other States join us through Microsoft Teams. It’s a meaningful way to extend our ministry. For privacy, I’ll withhold identifying details, but in August 2024 a woman I’ll call Barbara began participating. She drove more than 200 miles from Pennsylvania to attend her first meeting in person.  After that, she then started joining us via Microsoft Teams when she was able to. Barbara had been diagnosed with terminal cancer a few months earlier and was still processing the weight of that news. Because Christian-based cancer support groups are relatively rare, she sought out CSG to both receive and offer biblically grounded encouragement. As she became involved, she often emailed me updates, reflections, and prayer requests. At the time, she likely didn’t realize those email messages to me were becoming a kind of digital diary of her journey.

Barbara passed away on April 8, 2026 with her family by her side. After her death, I wrote her husband a detailed letter that included the emails she had sent me over the previous twenty months. I organized those emails chronologically so they would be easier—and more meaningful—for the family to read. Because families are often consumed with caregiving, I wanted them to see what mattered most to Barbara as her illness progressed. They may have heard many of these thoughts directly, but caregiving responsibilities and emotional strain can make it hard to take them in at the time. She may also have had more courage to say certain things to me that for whatever reason she never said to her family. I hope that, now, her words will resonate even more in the weeks, months, and years ahead. Barbara also had a deep desire to point others to Christ during her cancer journey. The treatments left her exhausted, and I’m not sure she was able to say everything she wanted to—especially to certain family members she prayed for. My aim in writing this letter was to weave her key reflections into one letter for her loved ones to read and consider.

As you read the letter, please focus on what mattered most to Barbara. I think you’ll find it deeply helpful to see life through the perspective of someone facing terminal cancer. Where did she invest her time and energy? How did she respond to difficult news? What did she want to accomplish in her remaining days? Where did she look for hope as her body slowly declined, becoming unresponsive to her oncology treatments?

 Here is the letter I wrote to her husband, whom I will refer to as Bob:

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April 8, 2026

Dear Bob,

On behalf of the Cancer Support Group (“CSG”) at my Church, please know how sorry I was to hear of Barbara’s passing from her cancer trial. While the news was difficult to hear, I am rejoicing in the fact that she is now with her savior, the Lord Jesus Christ.

Barbara Jones was a very special servant of God.  I have been involved in this ministry for almost twenty years, and it is rare that I run into someone who strives to consistently use their cancer platform to share the good news of Jesus like Barbara did.

I am grateful that the two of you were able to come to Cleveland, Ohio to visit, attending one of our CSG meetings and one of our CSG dinners. I am even more grateful that Barbara had a desire to email me over the years about her cancer trial, sharing what was on her heart while updating me on her prayer requests. Those emails meant more to me than she probably realized. Those emails also created a documented digital history which I was able to access to write you this letter.  More specifically, I have gone through my old emails from Barbara, copying and then pasting many of them as follows – I highlighted portions of them in bold print which impacted me the most:

• August 1, 2024 - My husband and I will be attending services at your Church 8/4/24. We are from out of town but are interested in the Cancer Support group that meets on Sunday. May we attend this Sunday? I was diagnosed with cancer 6/23. Was “cancer-free” 12/23.  Diagnosed with stage 4 abdominal cancer 3/24. I am currently receiving chemo treatments. Although this season of life is difficult, I continually receive blessings from our loving God. For that I rejoice.

• August 4, 2024 - Thank you for your warm welcome to the support group this afternoon. What a delight to meet brother and sisters in Christ while here on earth as we prepare for eternity with our loving Lord Jesus!  You all were an encouragement to us, especially when we think we are in this alone. As God peels away more of what I consider “normal” life, He also fills us with His Joy that will never be taken away, His peace that is beyond our understanding, and His contentment in His Word which gives true life eternal. We experienced more of His gentle lovingkindness this morning.

• December 5, 2024 - Thank you for the CSG updates. I continue to lift you all in prayer to our Heavenly Father. Even though we cannot be with you in person, we are eternally bonded in Christ. My oncologist is very pleased with results of MRI and CT scans!  Tumors haven’t grown and no new tumors.  I am receiving #23 chemo and will continue with every 2-week chemo indefinitely. One day at a time. Dr Smith doesn’t “predict” prognosis but is very positive that chemo is slowing cancer progression. Plans to begin a CSG at our church are starting with one-on-one visits/communications as most of us are not able to meet in person. Enjoy your Christmas luncheon and fellowship this Sunday!

• February 27, 2025 - Thank you for the monthly updates. Praying for the CSG is a privilege that I take seriously. Our church service doesn’t end in time for me to join the monthly CSG meetings, but I do read through the devotions and prayer requests. God has entrusted us with this cancer journey all the while providing everything we need in His strength, His mercies and The family of God here on earth. We hope to attend the June banquet. 

• May 6, 2025 - Good morning, Jim and CSG! We have been looking forward to the Spring Banquet since you told us about it last summer. That will be post-chemo weekend, and I trust God for mercies to be able to participate. Our plans to begin an in-person CSG took on new focus since most of our participants are unable to be in-person. Our church is growing in this ministry with faithful prayer warriors, committed “text messengers”, meal delivery, and consistent encouragement cards to those who are suffering within our church, throughout Pennsylvania and even other states The abundant outpouring of God’s tender mercies through His people is overwhelming! God continues to grant me the privilege of leading in worship at the piano. This is a ministry in itself as people are drawn to the testimony of God’s strength through our weakness. Every Sunday there is a line of people to talk with me after church services. Nothing that I have done but only what Christ continues to do within His Body. I hope that this update is an encouragement to you. CSG and church leadership are in our prayers.  May God be glorified and His Church unified!

• July 12, 2025 - We thank you for inviting us to the June CSG Banquet. What a blessing to be with you all for a delicious dinner and a message from your Pastor. We continue to pray for the two couples at our table and for the entire CSG community.  Barbara’s abdominal tumors continue to grow. Chemo infusions every 2 wks are losing effectiveness. She is on list to find a clinical trial study. We praise God for His tender mercies as we continue to live out each day to His Glory.

• September 11, 2025 - Thank you for continuing to include us in email updates. I appreciate being able to meditate on the monthly devotions and to pray for you all. Feels like family, which we are in Christ! I continue to pray for transition and unity at your church.  I am continuing the same chemo infusions even though abdominal cancer is progressing and the cancer has recurred in what is left of my stomach. Gastric surgery was 2 yrs ago this week. Dr Smith said he expected stomach cancer to return, which is consistent with the research I have done. He says the other abdominal tumors 5% increase in size is very slow and consistent with expected progression. So, every 2 week chemo will continue until clinical trial opens up. He has communicated with trial researchers the importance of getting me in ASAP. Very Sadly, This Sunday will be my last playing piano for choir and services. The neuropathy pain prevents me from effectively continuing. But my song in Christ will continue!

• December 6, 2025 - Thank you Jim and Kristina. The Keller quote means so much. I can testify that God’s strength takes over for our weaknesses and His power is made know to all. I was asked to speak to our youth group two weeks ago. I was so strong; A wonderful time of testimony. The youth responded powerfully.  I was rejoicing and thanking God for this “platform”. The next day my body started declining quickly. Thankful for the demonstration of God’s strength and plans for each of us in His perfect timing. Encourage the CSG family with those words.

• January 12, 2026 - Happy New Year to our CSG family! Time keeps on marching along, our circumstances change, our future may seem uncertain, but our God never changes! We were showered with much family time over Christmas. I received a blood transfusion Christmas week - that is what gave me strength to keep up with activities. The clinical drug trial began mid-December. So far, no bad side effects. Next MRI is 1/23. Taking in adequate nutrition is difficult causing weekly weight loss but I am trying! Years ago when I became involved with the Getty Sing Conference, I became interested in the country of Ireland. Some of our children desire for me to visit Ireland, so even in my weakened condition, I will join them on a trip to Ireland 2/28-3/7. This will be a quiet, relaxed week in a beautiful country. No rushed touring, just doing what I am able. My prayer for this trip is firstly that our concentrated time together will open and soften this family’s hearts to the Truth of the Gospel, and secondly that my health will hold up so that this trip will happened without incident. I feel as though this is a mission trip provided by those who need to acknowledge Christ as Savior! God is so good! 

• March 18, 2026 - Our daughter, son in law and granddaughter and I had an incredible trip to Ireland. A true testimony to God’s goodness in answering prayers for strength to make the trip!  The flights there went well. 14-month-old Sally was the best traveler. We saw more than we could take in, celebrating the things I could accomplish and adjusting to my weaknesses. Our rented cottage became home. Our conversations were sweet but no deep spiritual discussions. I do know that they have deeper appreciation for my heart and were willing to ask questions about end-of-life concerns. I wouldn’t change anything about the trip. My health has been declining since then. I am no longer in the investigational drug study since scans do not show progress.  Tomorrow, I meet with the oncologist to discuss last resort chemo pill Lonsurf vs starting Hospice care. Please pray for us in this important decision. I am not ready to give up but my body has no strength, and my mind is so weary. Every day/night has become a struggle. I want to end strong in the witness of the Gospel. That is my deepest desire.

• March 19, 2026 - My hemoglobin was 6.8 at the clinic this morning so the oncologist sent me to the emergency room. Our discussion about chemo pill versus Hospice is on hold for now. I’m awaiting to be admitted here at university of Pennsylvania Hospital. I’ve had a unit of blood. An abdominal ultrasound was done. Hopefully tomorrow I will have an upper G.I. scope to look for source of bleeding. I am so grateful that my abdominal pain is manageable today. God‘s mercies are new every morning. You may send me a link to your blog, I would appreciate that. I sometimes post my thoughts on Facebook all the while giving glory to God. My thanks to both of you for keeping up with us and for supporting us through this journey.

• March 21, 2026 - The large tumor in my stomach is bleeding so they put a temporary fix on it during my upper G.I. I was discharged last night. I will see radiation clinic on Monday, then 5 radiation treatments will be scheduled probably starting Wed. They will target 2 areas in hopes of curbing bleeding. God is my shield, my rock, and my fortress. Trusting Him in all things as you all do also.

• March 28, 2026 (her last email to me) - I was in the hospital again this week. Not able to have bowel movements and not eating. I came home yesterday and am now under hospice care. The whole family is here and are taking unbelievable care of me. God is so good. I am not ready to leave this earth, but I am not afraid. We (believers) all will be together in heaven soon. My love and regards to CSG.

As noted in the first bullet point above, I met Barbara Jones via email on August 1, 2024, when she reached out to me asking to join the next CSG meeting. At the time, I thought it was just another email from a prospective member of our group. I had no idea she was going to encourage me in so many ways over the next 20 months. You see, I get a lot these types of introductory emails saying, “I hope to join CSG one day”. Sadly, I never get a chance to meet a lot of the people who send me emails like this as they just never make the effort to come to our group. Perhaps they are too scared of showing up to cancer group to discuss their own mortality and the implications of their cancer trial?  Perhaps a cancer diagnosis is just too overwhelming for them to contemplate and discuss in a group setting?  Perhaps it is something else? While many struggle to come to grips with the implications of their cancer diagnosis, Barbara was never too scared, overwhelmed or concerned to share the good news of the Gospel with others who had cancer. She clearly understood the implications of her diagnosis, but it did not stop her from ministering to others. She was not worried about driving over 200 miles to get to one of our meetings or CSG dinners in Cleveland, Ohio to receive and give biblical encouragement to others impacted by cancer.  Barbara was confident and steadfast in her belief that Jesus was her only eternal hope should she not survive her cancer trial.

As the volunteer ministry coordinator for CSG, my role is to serve people impacted by cancer and to point them to Christ in the midst of their medical trials. As a two-time cancer survivor, I feel a deep calling to this work, and over the past 19 years I’ve had the humbling privilege of walking with—and ministering to—hundreds of individuals and families. When I received Barbara’s email on August 1, 2024, I had no idea that, in time, she would encourage and strengthen me as much as I hoped to encourage her. Barbara never wanted her cancer trial to be about her. Instead, she consistently sought to use her circumstances to draw attention to the Lord Jesus Christ and to bring glory to His name. In doing so, she repeatedly reminded me of CSG’s mission: to see unbelieving people become committed followers of Jesus. I am profoundly grateful for the impact she had on me and on others in our group. Her courage humbled me, her gospel focus invigorated me, and the Lord used her life and words to shape me into a better ministry coordinator. She truly was rare and deeply special.

Of all the quotes I highlighted in Barbara’s emails, the one that stood out most to me came from her May 6, 2025, message. Speaking of her piano playing for the church worship team, she wrote: “This is a ministry in itself as people are drawn to the testimony of God’s strength through our weakness.” Scripture is filled with examples of God using weak people for His glory, and Barbara wanted to use her cancer platform in the same way—to show others that she was clinging to Christ even while facing a terminal diagnosis. It’s hard to miss a woman playing piano in front of the congregation while undergoing treatment for stage 4 abdominal cancer; more than once, I’m sure people wondered how she could do it. And through it, she humbled and challenged many as she served the Lord with her gifts. When confronted with a diagnosis like hers, many people turn inward—trying to complete a bucket list or searching for something to give them hope. Barbara chose a different path: she used her place in worship as an opportunity to minister. After all, why would she keep playing if she didn’t truly believe the good news of the gospel? She understood that trusting God in good times is one thing, but clinging to His promises in the darkest season speaks with a different weight to friends, family, and the church. Barbara’s life testified that God’s strength is most visible through human weakness, and that true faith shines brightest when circumstances are bleak. The world often treats cancer as a death sentence; the unbeliever has no hope beyond the grave and faces eternal separation from God. But the believer has a promised hope (eternal life) with Jesus Christ. Therefore, every Christian will be victorious over their cancer trial, even if the Lord calls them home through it.

One of the blessings of a cancer trial is that it forces a person to face mortality and to consider what lies ahead if he or she does not survive. If you read Barbara’s emails above, you’ll see that her “exit plan” was to trust the Lord Jesus Christ—regardless of the outcome of her cancer trial here on earth. As she wrote on March 28, “God is so good. I am not ready to leave this earth, but I am not afraid. We (believers) all will be together in heaven soon.” And on March 18, she told me that her deepest desire was “to end strong in the witness of the Gospel.” Why would she say that? She explained it plainly in one of our CSG meetings last year (2025): she understood that we are all terminal, and that apart from Christ we are all facing eternal separation from God. She longed for her friends and family to become followers of Jesus.

Romans 10: 9-10 tells us: “if you confess with your mouth that Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved. For with the heart one believes and is justified, and with the mouth one confesses and is saved.”

On behalf of everyone in the Cancer Support Group, please know that we are praying for the Jones family during this difficult time. I hope that reading Barbara’s emails will encourage you as much as they encouraged me throughout the past twenty months. Praise be to God for Barbara Jones, and for the way He used her cancer trial to point others to the Lord Jesus. Her testimony of faith will, I believe, continue to impact many lives for years to come. Thank you for allowing me the opportunity to share more about her relationship with CSG in this letter. We will miss her dearly.

Humbly,

Jim Risk

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Barbara was two years older than I was when she passed away on April 8, 2026. She was born and raised in Kentucky and attended a Christian college in North Carolina, where she earned a B.S. in Nursing. She met Bob soon after graduation from college, and her father, a pastor, officiated their wedding in 1987. Together, they were blessed with five children. Her life was centered around the church, her music ministry and her family.

Her obituary said, “Barbara had a deep and abiding love for Jesus Christ that permeated every part of her life. Her faith was not only something she professed but something she lived out intentionally each day.” Yet in my conversations and emails with her, it was clear that she carried a burden for some of her children who did not share her faith. We don’t know all the details, but we do know that one of her main reasons for traveling to Ireland with her family in March (2026) was to share the gospel with them one more time. She said their conversations in Ireland were sweet, but there were no deep spiritual discussions. Perhaps her children drifted from the faith in college, or through trials in their own lives. Perhaps they never truly embraced the message of the gospel. Perhaps Barbara wished she had been more intentional in witnessing to them during their formative years. We may never know the full story as she passed away in less than a month after returning home from Ireland.

One reason I wrote this letter is that Bob can choose to share it with their children. I hope Barbara’s emails—and the words she may not have had the strength to repeat—will carry even more weight in the months and years ahead. Perhaps her children will return to this letter in their own seasons of trial, when they are searching for hope. Perhaps her words will mean more now that she is no longer here.

On the front page of the April 24, 2026, edition of the Cleveland Plain Dealer, an article titled “Terminally Ill Ohioans could get an end-of-life option” appeared on the front page. The article opened with these sentences:

“Rep. Eric Synenberg joined advocates for medical aid in dying at the Statehouse on Thursday to announce legislation that would allow it for terminally ill Ohioans.  Currently legal in 13 states and the District of Columbia, medical aid in dying, or MAID, allows terminally ill, mentally competent adults with six months or less to live to hasten their death by self-administering a lethal dose of medication prescribed by a physician.”

Over the years, as I’ve walked alongside people facing cancer, I’ve seen many different responses to a terminal diagnosis. The reactions vary, but one theme surfaces again and again: the insistence that the patient must take control of the situation. That impulse reflects an existential mindset—one that assumes individuals (not God) are responsible to create their own meaning and identity. Our culture repeats this message in countless ways by suggesting we are the captains of our own ships and the masters of our own destinies. The Plain Dealer article is one more example. God may have many reasons for allowing a long and painful cancer trial, but surely one is this: to bring a person face-to-face with mortality and its implications—and to consider what becomes of the soul if one does not survive.

As I read Barbara’s emails again while writing this blog post, one thing is clear: she did not want to leave this earth and her family. Yes, she prayed for more time—but that prayer did not define her. Instead, she kept returning her focus to the goodness of God and to the eternal hope which only He can provide. If I had to summarize the themes that surfaced repeatedly in her bold messages above, they would look like this:

• God is so good—His mercies are new every morning, and I rejoice.

• I’m praying God replaces what feels “normal” with joy, peace, and contentment in His Word.

• God entrusted us with this cancer journey and supplies all we need through His strength, mercy, and His people;

• God strengthens me to testify (including to the youth group), and I thank Him for this platform.

• God never changes—my desire is to finish strong, trusting Him as my shield and fortress, until we’re together in heaven.

  
  

Barbara’s response to her terminal cancer trial stands in stark contrast to the approach promoted by medical-aid-in-dying advocates and legislators in Ohio who are seeking to legalize physician-prescribed medication that a patient may use to end his or her own life. The language can sound compassionate—described as an “end-of-life option” in which a terminally ill person self-administers a lethal dose prescribed by a physician—but the underlying aim is to place final control of life’s last chapter in human hands, including the date and time of death. This reflects the wider message our culture often repeats: that we are the captains of our own ships, able to direct our destiny by our own strength. Along similar lines, the suffering person is told, “Be strong—you can do this; you’ve got this.” In other words, when you are at your weakest or in the most pain, call the doctor for a lethal dose prescription. In direct contrast to the proposed Ohio legislation, scripture offers a completely different and countercultural message: God’s power is displayed most clearly in our weakness, so we must turn to Him in our darkest hours.  2 Corinthians 12:9 tells us:

"My grace is sufficient for you, for my power is made perfect in weakness." 

Barbara knew her illness was terminal. Yet her response to that sobering reality was not to roam the world in search of a miraculous cure. If she had wanted, she likely could have found someone willing to take her money while promising to extend her life. Instead, Barbara chose to focus on her relationship with the Lord Jesus Christ—asking Him to help her finish strong and while using her platform to point others to Him. Matthew 16:24 tells us:

“Then Jesus told his disciples, “If anyone would come after me, let him deny himself and take up his cross and follow me.”

As Jesus teaches in the verse above, we are to deny ourselves, take up our cross, and follow Him. This is a call to trust Christ alone for eternal life and to bring our lives into alignment with God’s will rather than our own desires. Most people facing terminal cancer are not ready to die when their time on earth is done. So, when Barbara wrote in her final email on March 28^th that she was not ready to leave this earth—and yet she was not afraid—her words were both humbling and deeply encouraging to me. If you have ever visited someone in hospice care, how often do you hear, “I am not afraid”? Once again, her response runs completely contrary to what the world teaches. God wants us to remember that His power is made perfect in our weakness. Our part is to deny ourselves, take up our cross, and follow Christ—and the promise is eternal life with Christ in heaven.

One of my favorite old hymns is The Old Rugged Cross, by George Bennard. If you have the time, turn on Spotify or Pandora and listen to Carrie Underwood sing this great hymn.  Here is what the first stanza and Chorus say:

“On a hill far away, stood an old rugged Cross

The emblem of suff'ring and shame

And I love that old Cross where the dearest and best

For a world of lost sinners was slain

Chorus:

So I'll cherish the old rugged Cross

Till my trophies at last I lay down

I will cling to the old rugged Cross

And exchange it some day for a crown”

The hymn contrasts the world’s rejection of the cross with the believer’s love for its spiritual meaning. It reminds us that while the world may despise the cross, Scripture calls us to embrace the significance of the cross—a decidedly countercultural message. The repeated promise to “exchange it some day for a crown” offers a vivid picture of trading present suffering and faithful endurance for future glory, reminding us that today’s trials are temporary when weighed against eternal reward. Barbara understood this: clinging to the cross meant her suffering in this world would one day be exchanged for a crown.

Let’s be honest—clinging to the cross during a terminal cancer trial is a difficult assignment. I’ve seen many Christians move through life with its usual ups and downs, and then one blood test changes everything. Abnormal results lead to a serious cancer diagnosis, and what once felt steady can suddenly feel shaky. It’s harder to trust the Lord when you feel betrayed, forgotten, or burdened by prayers that seem unanswered. Over the years I’ve heard many people say, “I just need to make it to my daughter’s wedding,” or “my son’s graduation,” or whatever the next milestone may be. Those are understandable desires, and there is nothing wrong with praying for more time, less physical pain, a new treatment protocol, or access to a clinical trial. Yet, as we learned from Barbara’s story, we may not always be given the extra time we think we need. When you reach the point in your cancer trial where you can’t seem to catch a break, Barbara’s example reminds us to keep trusting the Lord’s plan for our lives. The late Presbyterian minister R.C. Sproul once said:

“I do not always feel his presence, but God’s promises do not depend upon my feelings; they rest upon his integrity”

It has always amazed me how many people facing cancer—even terminal cancer—still reject the message of the Gospel. There are likely many reasons for rejecting the good news of the Gospel, but Alistair Begg (TruthForLife.org) points to pride and moralism as a fundamental driver of this response when he said:

“It's an offense to pride - intellectually and morally – intellectually, because a person says I'm too clever to believe stuff like that - I'm too clever to believe that a Galilean Carpenter, who lived 2000 plus years ago and died on a cross, is actually the answer to the entire world's predicament. I'm too clever for that. Or - I'm actually too good. I don't need that - I don't need anyone dying on a cross from me. I'm a moral person. I'm a fairly decent soul - I pay my taxes - I look after things. It is offensive to people's pride”

If you are facing a terminal cancer diagnosis, do you have an exit plan if you do not survive your current medical trial?  If not, will you let pride or moralism get in your way to coming to faith in Christ?  Do you recognize that we are all terminal—and that we all stand in need of a Savior? As we learned from The Old Rugged Cross Hymn, one day we will all need to lay our trophies down as our accomplishments earned here on earth will be meaningless. If you are facing a serious cancer trial, please remember Matthew 16:24 where Jesus said we are to deny ourselves, take up his cross, and follow him, so that—like Barbara—we can have true eternal hope.  Thank you Barabara for your witness, testimony and utilizing your cancer platform for the Glory of Christ.  It is my desire that our Lord will use the words in your diary to convince others facing terminal cancer to find hope in the Lord Jesus, our only eternal hope.

“Then Jesus told his disciples, “If anyone would come after me, let him deny himself and take up his cross and follow me.” (Matthew 16:24)

Jim Risk, a two-time cancer survivor, is the volunteer Ministry Coordinator for the Cancer Support Group (CSG) at a non-denominational church in NE Ohio. Jim and his wife, Kristina, have participated and served in CSG, a Christian ministry, since 2007.