Christianity Today September 18, 2026 8 min signal 2026-09-18

Trapped in China, terminally ill pastor seeks return to US family

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Christianity Today

September 18, 2026

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Photo courtesy of John Cao

In April, Jamie Powell walked into a hospital room in Changsha, China, with her eldest son and his fiancée. Laying on the hospital bed was her husband, John Sanqiang Cao, gaunt and fighting late-stage prostate cancer that had spread to his spine.

The couple had not seen each other face-to-face in nine years—the Chinese government had imprisoned Cao for seven years on fraudulent charges of “human trafficking” due to his mission work by the China-Myanmar border. Then after his release in 2024, authorities barred him from leaving China.

“Last time, you came to see me outside the detention center, and this time, you came to see me in the hospital,” Cao, 67, recalled telling his wife. “Both times, I was not free. I owe you so much, and I will never be able to repay you in this lifetime. You are truly God’s greatest servant, quietly paying the price behind me.”

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Now Cao, who has gone through six rounds of chemotherapy, is seeking one last chance to return to the US to spend his remaining days with his family. Last month, ChinaAid and other international religious freedom groups started a campaign to petition President Donald Trump to raise Cao’s case to Chinese president Xi Jinping during Xi’s upcoming visit to Washington on September 24. ChinaAid believes this could help Cao return to the US, as Trump’s mention of Zion Church’s Jin “Ezra” Mingri to his Chinese counterpart led to Jin’s release in July.

“When a person is in the final stage of life, you hope to be together with your family,” Cao told CT over Zoom from his home in Changsha, the capital of Hunan Province in southern China. “If you’re going to leave this world, then it would be better to do so in front of your family, wouldn’t it?”

Born in Changsha in 1959, Cao became a Christian as a college student after befriending an American couple with whom he was practicing English. After graduation, he refused a government-assigned job teaching at a rural school and started preaching and teaching at house churches. In 1985, Cao moved to North Carolina to study English and American literature at Campbell University. He met Powell while attending a Chinese church in Raleigh, and the two got married in 1988.

While Cao became a permanent US resident in 1990, he refused to give up his Chinese passport as he felt called to return to China to do missions. After several years of pastoring a Chinese church in North Carolina, Cao, Powell, and their toddler moved to Hong Kong in 1994 so that Cao could serve Chinese house churches full-time. He established Bible-based English schools in central and southern China.

In 2014, that work expanded to Myanmar’s Wa State, an impoverished region bordering China. With volunteers from Chinese house churches, he built 17 schools and a drug rehab center. But while crossing the border back into China on March 5, 2017, Cao found Chinese authorities waiting for him. They detained him and charged him with “organizing illegal border crossings,” which led to seven years in prison. According to China Aid, an officer told Cao, “What you have done was good, but you have done too much of it.”

In prison, he spent his time writing hundreds of poems and evangelizing his cell mates while living in crowded conditions and eating meager meals. One poem spoke of his desire to continue his witness:

With Gospel shoes upon my feet, I run light-footed at the call—leaping ravines, crossing mountains, wind rising at my heels; beautiful are the footsteps of those who are sent. The road ahead is still long; I press on, and grow the stronger. Onlookers, stirred, long to join the ranks—generation after generation walking on, without end.

In 2021, China Aid collected his poetry and published them in a book.

After his release from prison in March 2024, Cao moved in with his mother, who is now 90 years old. Police installed surveillance cameras at their apartment to monitor his whereabouts and visitors. Whenever he leaves Changsha, at least three plainclothes officers come along and ask him to report where is going, Cao said.

He applied for a new passport, as his previous one expired while he was in prison. But shortly before his planned trip to the US in May of that year, public security officers came to his house and “forcibly took away my passport,” Cao said. Later when he tried to submit another passport application at the local public security bureau, he was told, “You cannot apply for a passport. You are under control.”

Twice Cao has written to the minister of Public Security requesting a passport, asking them to allow him to return home out of humanitarian considerations, but he has not heard back yet. Local public security officers also said they couldn’t help as the decision was up to authorities in the central government in Beijing.

Cao argues that in all his activities, he has never criticized the Chinese government. His work in Myanmar, such as the drug rehab, sought to stop drugs from entering China from Myanmar, while the schools taught children Mandarin.

“In a sense, this was also a form of ‘strategic engagement’ … promoting Chinese culture, and it was consistent with China’s national policies,” he said. “I simply held on to my Christian faith and wanted to do something for this country and its people.

“If I could get to the United States, I would also not be going around making antigovernment statements,” he said. “So why do they have to keep me here?”

In Changsha, Cao preaches and teaches at a local house church that meets online due to pressure from the government. He lives off his mother’s retirement income of 6,000 yuan (less than $900 USD) a month, as he cannot work due to chronic illnesses that have resulted from his time in prison.

That has led to financial problems this April, as Cao began experiencing severe pain in his leg preventing him from sleeping. Doctors initially thought he was suffering from a simple sprain and prescribed anti-inflammatory medication, according Cao’s public prayer letter.

An MRI two weeks later found that he had a spinal tumor. A biopsy found that the tumor was cancerous and had spread from his prostate. Doctor diagnosed him with stage 4 prostate cancer. If treatment went well, he might live for another a year or two.

Cao said when he heard the news, he didn’t have much a of reaction. “I wasn’t afraid of prison, and I’m not afraid now,” Cao told CT. “From a human perspective, the hope I had in prison was more concrete. Now, this expectation—it’s almost like a life sentence. … [But] the Bible puts it well: Seeing the Lord is a thing of tremendous joy.”

Doctors initially scheduled surgery for April 29 to remove the tumor. But the night before, a friend whose wife was paralyzed from the same procedure warned Cao against the surgery. Cao decided to cancel the surgery and instead underwent radiation therapy.

Without insurance, Cao has struggled to pay his medical bills. Yet friends from his church and other churches he has served in the past have helped him pay the fees. Church members take turns preparing meals for him every day, while one young man moved in to help Cao and his mother with their daily needs.

“God’s care for me has been extraordinary, far beyond anything I could have imagined,” Cao said.

Today, Cao is finished with his chemotherapy and says he has gained back the weight he lost during the treatment. When he’s not resting, he spends his time reading the Bible and praying, as well as organizing the poems that he wrote in prison and posting them on Chinese social media.

He’s praying that authorities will allow him his passport before his life is over so that he can meet his 1-year-old grandson and spend his remaining time with his family. He also noted that in China and around the world, many people are praying for him, and he believes that God could also heal him, allowing him to continue his lifelong ministry of sharing Jesus with the people of China.

“I have a very strong desire to go and see the face of the Lord Jesus,” Cao said. “I spent seven years in prison, which was almost like going through hell and coming back. So if I were to go to heaven after that, I think it would be a very good thing.”

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