The hard work of living in the face of death.

This study examines, from the patient's perspective, the work of trying to live with advanced cancer at the same time as facing the immediacy of death. The findings are part of an exploratory qualitative study that examined the first-hand accounts of seven patients being cared for at an urban cancer research center who were living with advanced disease. Using interpretive phenomenology, a series of in-depth, semistructured interviews were audiotaped, transcribed, coded, and organized into themes. Three subthemes emerged from the data that reflected the hard work that these individuals undertook. These were orientating themselves to the disease and maintaining control, searching for and creating a system of support and safety, and struggling to find meaning and create a legacy. The findings confirm that living with advanced cancer in the face of death involves hard work on the part of the patient.