Hours prior to taking the stage in Miami, Lady Gaga canceled her latest stop on the sprawling Mayhem Ball Tour due to the “significant risk” of damaging her vocal cords should she perform.

The superstar singer was scheduled to run through her electric two-and-a-half-hour setlist, featuring hits past and present, at the Kaseya Center, where she previously performed Sunday and Monday.

“Hi everyone I am really so so sorry but I need to postpone tonight’s show in Miami,” she wrote in an Instagram Story. “During rehearsal last night and my vocal warmup tonight my voice was extremely strained and both my [doctor] and vocal coach have advised me not to go on because of the risk it poses.”

She continued, “I want to be hardcore and just push through this for you but I don’t want to risk long term or permanent damage on my vocal cords. There is a significant risk based on all our combined experience with a show like ours and as you know I sing live every night — and even though this was a hard and agonizing decision I would be more afraid of the long term implications on my voice. I hope you can forgive me and accept my sincerest apologies for any disappointment. Let down. Inconvenience.”

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“I tried so hard to avoid this,” she concluded. “I take serious care of myself to be able to put on this highly demanding show. I love my fans so much. Respect you and hope you can accept my sincere regretful apology. We are trying to reschedule the show as quickly as possible.”

It’s unclear if the Oscar and Grammy-winning multi-hyphenate will resume her tour during the next stop, which includes dates for New York’s Madison Square Garden for Sept. 6 and 7. Having kicked off mid-July, the tour of her seventh album will also include an international leg that includes cities like London, Milan, Barcelona, Paris and more.

A somewhat common occurrence given the strenuous nature of stadium tours, other top artists like Adele, Shakira and Ariana Grande have had to postpone shows due to vocal issues.