Luke Bryan is playing a balancing game, weighing show cancelations against the strength of his voice as he continues his tour across the country.
The 30-time country chart-topper has canceled or postponed three shows already with the latest Sunday in Brandon, Mississippi.
"I am regretfully going to have to cancel my show there tonight," Bryan posted on Instagram Sunday morning. "Under doctor advisement after taking 6 days off to heal I attempted to sing at both shows Thursday and Saturday and it was a struggle."
The cancelation in Mississippi came after a sold-out show at Bridgestone Arena in Nashville Saturday night.
He's scheduled to perform in Cincinnati, Ohio, at the Riverbend Music Center on Thursday.
During his Nashville show, Bryan described his illness as nothing more than a "head cold."
Despite several days of rest, Bryan suffered several coughing fits between songs Saturday.
Bryan previously postponed a show in Salt Lake City, Utah and canceled another in Boise, Idaho, before tapping Lainey Wilson to replace him as headliner at the Watershed Festival in George, Washington.
In his Instagram post on Sunday, he said he risks further strain each time he performs.
"Every show I sing I'm setting my voice back," he wrote. "I will continue to do everything I can to get better. Please know how much you mean to me and how heartbreaking this is to do."
Ticketmaster noted the show was canceled, rather than postponed, and refunds would be issued at the point of sale.
Bryan persevered through his setlist Saturday but altered it to better suit his condition. He was open and honest with the crowd that he was not at peak performance and several songs would be performed in an acoustic set.
About 30 minutes into the show, he frankly said "I'm dying up here," before continuing on.
The changes threw Bryan off at least once, noting he was in the wrong key for one song.
"My band has no idea what we're doing; they're holding on for dear life," Bryan joked.
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In the middle of his tour, Bryan will stop for a return to Las Vegas.
Bryan will perform 12 nights starting Aug. 30 at Resorts World in an intimate theater where the furthest seat from the stage is only 150 feet away.
"In an incredible modern venue, we're trying to put an iconic, globally-acceptable, stadium-style show with arena rock-style elements and moments where it's just me, stripped down with an acoustic guitar, playing the piano, or telling jokes," Bryan said.
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