How do you pray for someone with a condition that doctors call "incurable"? I had faced that question as a church member, as a church leader, and as a seminary professor. But when I was diagnosed with an incurable cancer at the age of 39, I faced the question in a new way.

On one hand, when we pray in such a situation, we should not be paralyzed by fear. Like the Psalmist, we can bring our whole range of emotions before the Lord: our anger and grief, frustration and fears, longings and dreams. Whatever we're feeling, we can trust that God hears our cries, our groanings. Even the most desperate prayers are offered in hope in the Lord and his promises—promises fulfilled in Christ. I have been grateful for all of the prayers offered for my family and me, knowing that they are taken up and perfected in the intercessions of Jesus Christ himself.

On the other hand, when we pray with someone else, it makes an impact upon that person. I sometimes felt buoyed and my faith strengthened by the prayers of others. And while it's not my job as a cancer patient to act as "prayer police," at other times the prayers left me feeling alienated and manipulated.

My diagnosis was unexpected. My wife and I had just celebrated our tenth anniversary, and we were living the busy lives of parents of a one and three year old. But my immune system seemed to be weak, so I underwent a battery of tests. Because of my relatively young age, we thought that an active cancer was very unlikely. We were wrong. When the results came in, the diagnosis was clear: the cancer was active and had already been eroding away my bones. I started intensive chemotherapy the next week.

Amid the shock, I was blessed with a congregation, seminary community, and group of Christian friends who prayed fervently for me and my family: in small groups, one-on-one, and in prayer services. But it was hard to explain my situation: my cancer could be treated through chemotherapy and a stem cell transplant. But there is no cure. Even if I go into remission and no cancer is detected in my body, the doctor was clear: "It will come back."

Thus when others laid hands on me and prayed for a "complete cure," I was not sure what they were praying for. Would they be praying for a "complete cure" if I was 85 and struggling with dementia? If not, what puts me in a different category?

For someone with incurable cancer, we can and should pray for healing. But not without lament.

Sometimes I was asked what they should pray for. I was glad to be asked. I requested prayer for my family and me, amid the challenges of treatment, that God would use the treatment to bring me into "deep remission" and that he would be working the whole situation to his glory. Why "deep remission?" If my remission was light, my lifespan would be much shorter. With a deep remission, I would have time to serve my family and vocation for 5-7 or even 10 years before the next round of intensive treatment. Relapsed cancer is harder to treat, and the mortality rate for my cancer is very high.

But to pray for a "complete cure" rather than "deep remission" seemed less like an act of faith than a denial of the reality I was facing.

I received numerous prayers for a cure—often with verses like Matthew 18:19 quoted, "If two of you agree on earth about anything you ask, it will be done for you by my Father in heaven." I appreciated the fervent petitions. Sometimes people were frustrated, even offended, when I asked that they pray for "deep remission." Did I believe that God could bring complete healing, even to an incurable cancer? Yes—in the sense that it would not be beyond God's power. With Jeremiah the prophet, we can pray to the Lord that "it is you who made the heavens and the earth by your great power …. Nothing is too hard for you" (32:17).

But praying for healing for someone with incurable cancer is akin to praying for someone who has lost a limb. God can provide healing. But until the full restoration in the final resurrection, prayers of healing in circumstances like this need to be paired with prayers of ongoing lament—because nothing will turn back the clock. Even if my cancer completely disappeared—and I had no detectable levels left—doctors would expect the cancer to return.

Thus even if I was miraculously cured, I would need to continue on maintenance chemotherapy for the rest of my life, along with cancer tests every three to six months. That's still a deep loss. Whether God provided healing now, over a long period of time, or in final glory—there is no question that we can and should pray for healing. But not without lament.

There is no how-to list for praying for someone with an incurable disease. But here are some suggestions:

Listen. Ask. Listen carefully to the concerns of the ones you are praying for. If possible, ask them how they would like you to pray for them. They may not have an answer. Or the answer may surprise you. But starting by listening and asking is a way to honor and support those in need.

Pray with the Psalms. Whether in the hospital bed or at a prayer service, the most powerful and comforting prayers offered to me were from the Psalms. They don't cover up the loss—they bring anger and grief before God. "My heart is stricken and withered like grass; I am too wasted to eat my bread." And yet they bring all of this in petition before the faithful God of the covenant. "Hear my prayer, O LORD; let my cry come to you. Do not hide your face from me on the day of my distress" (Ps. 102:4, 1-2).

Present your petitions in light of the Lord's Prayer and Gethsemane. We are to bring our requests before God, in light of Jesus' command and promise to answer our prayers. But this does not mean that we just pray for a comfortable lifestyle. Remember that our model prayer, the Lord's Prayer, was enacted by Jesus at Gethsemane. He asked to be led from the time of trial, to be delivered from evil. He was right to ask, to present his heart before the Father. Yet, the petition of the one who defines perfect faith—"Jesus the pioneer and perfecter of our faith" (Heb. 12:2)—was not granted. His cup of suffering was not taken away.

All prayer involves a relinquishment of our will to the Father. My friends wanted healing, strength, and courage for my family and me—and they prayed for it, as they should. But our faith does not cause answered prayer; moreover, we must remember that the center of God's revelation is not a secret about how to live a happier, healthier life, or a message that God's work is transparent to our eyes in a steady, upward journey. As ones united to Christ by the Spirit, we follow the way of the crucified Lord. We should not seek suffering, but we must also remember that God works in surprising ways: through the way of the cross.

Pray in solidarity. Those in crisis often feel alienated, so make the most of your prayerful, Christian solidarity with them as brothers and sisters in Christ. For example, I had to shave my head in preparation for intensive chemotherapy. After finding out when this would happen, over a dozen Christian friends shaved their head the same day. The seminary turned it into a joyful event that my family could also attend. I was in the hospital, but a group of supporters joined to cheer me on via Skype—cheering on the others getting a head-shave as well. There were tears, but also a lot of laughter. And it wasn't just a one-time event: when I looked in the mirror, I did not feel isolated; I knew that others were with me—praying every time they were reminded of their funny-looking shaved heads. It was a living prayer displaying Paul's words that "you will fulfill the law of Christ" when you "bear one another's burdens" (Gal. 6:2).

Find care for yourself from those not at the center of the crisis. A cancer diagnosis affects many people, and it is crucial to find appropriate places for support, prayer, and encouragement. But as you seek to "bear one another's burdens" in a crisis, it's essential to first remember the people who should be the main focus of your prayers and care. Imagine a circle with the main sufferers and their families at the center, close friends at a second layer of the circle, other loved ones in an outer layer of the circle. Then, look and see what part of the circle you occupy.

The best prayer was from a girl with Down syndrome: 'Jesus loves you! God is bigger than cancer.'

Here's the rule of thumb: from wherever you stand, keep your eyes, prayers, and support directed toward the inner part of the circle, and get your own support from the outer part. Sometimes church leaders go to a person in crisis or their family and say, "I don't know whether I can handle this!" That is profoundly unhelpful. Instead, seek out friends who are not at the center of the crisis for your own support.

Finally, remember that prayer is not about offering magic incantations that will make everything better. In prayer, we bring our whole selves before the gracious covenant Lord in trust: lamenting, petitioning, thanking, and hoping in God.

It does not take a Ph.D. in theology to know how to pray for someone with incurable cancer. The most powerful prayer that I have received for my cancer was from a 15-year-old girl with Down syndrome in my congregation. She made me a colorful card, a week after my diagnosis, and wrote these words on it: "Get well soon! Jesus loves you! God is bigger than cancer!"

As soon as I saw it, I wept with tears of joy and wonder: God is bigger than cancer. My cancer story was already developing its own sense of drama—like a story that closes in the sky, enveloping my whole world so that nothing else could creep in. But God's story, the drama of God's action in the world, is bigger.

This girl wasn't denying my loss but was testifying to a God who is greater, the God made known in Jesus Christ who shows us that "the light shines in the darkness, and the darkness did not overcome it" (John 1:5).

Praying for someone with an incurable condition is not mainly about trying to "fix a problem" or even "finding the right words." It's about joining the suffering in crying out to a gracious and powerful God, acting as living testimony to God's promise in Christ that darkness will not have the final word. LJ

J. Todd Billings is associate professor of Reformed theology at Western Theological Seminary in Holland, Michigan. He is the author of Rejoicing in Lament: Wrestling with Incurable Cancer and Life in Christ (Baker).

Hope in a Hospice

The power of presence is its own gospel message.

One of our HIV patients now had full blown AIDS. He refused to allow me to speak with him for almost three months because of what he thought I represented—and understandably so.

But over time he was willing to see me, and we got to know one another, talking mostly about his love of hunting and fishing. We never talked about God, never talked about faith, never opened the Bible—not once. But he believed that I was there for him, not for my own need to see another person "get saved."

On his last (and final) trip, he had me paged to his room. His family was in the room with him.

"I just need you to sit here and talk to me," he told me. "Just hold my hand and talk to me. I'm dying."

"I know," I said.

I realized that we needed to go somewhere we hadn't yet. So very quietly, very peacefully, I said, "My friend, if indeed you're dying today, I need to ask you something. Is that okay?" He nodded. "Have you thought about what will happen to you beyond today, if today is your last day on Planet Earth? What would happen to you? Where would you go?"

"It's interesting that you would ask that question, Rev. McCray," he said. "Because the last time we met, I went home and sat in my backyard, and I had a conversation with God. I asked him to forgive me of my sins. Then I called my family members, and I reconciled to some of my family members that I had been at odds with. I asked God to forgive me. I asked Jesus into my heart."

I was flabbergasted. It was a day of epiphany that I shall never forget. Then he said, "But really I just wanted to see if you would sit down and hold my hand without a latex glove."

So we sat there hand in hand. Until he quietly slipped away. That's when I understood the power of Christ's presence, and my role of being a deep listening presence. Being able to connect with people, being available, being present, allowing that person to take you with them on their journey. It becomes a shared journey.

I didn't preach. I didn't quote a Scripture. I just needed to be present and to display the love of God to this man. Somehow God took over from there.

Percy McCray is director of pastoral care at the Cancer Treatment Centers of America in Zion, Illinois, providing spiritual support for patients and caregivers.

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