Annually, approximately 10,000 people in Ireland die due to cancer, with many following a terminal cancer (TC) diagnosis. For TC patients, the awareness of their approaching death may lead to psychosocial and spiritual distress as they come to terms with their advancing illness and move towards death. This study aimed to explore the phenomenon of living with TC. A qualitative meta-synthesis of 37 studies was completed in phase one to examine and synthesise evidence on spirituality as experienced by TC patients. These findings highlighted how spirituality can positively impact the lives of TC patients and can be a transformative experience that provides peace at end-of-life. In phase two, ten (N=10) semi-structured interviews were conducted with TC patients to explore their lived experiences. Following interpretative phenomenological analysis, six themes were identified. While living with TC, participants focused upon Recovering Control in Uncertain Times, as while they could not control their prognosis, they regained control over other aspects of their lives. As participants experienced existential angst, they were Gaining an Increased Awareness of Time and focused on living well and leaving a legacy. They described this experience as Negotiating a Changing Identity as they became a TC patient and re-defined themselves following their diagnosis. Participants reported Finding Comfort through Connection with themselves, God and nature. They highlighted that Navigating the Social World required them to detach from some relationships and to cultivate more meaningful ones with those who mattered most. Participants posited that Journeying with Hope was dynamic as they may have experienced feelings of hopelessness but hope helped them to live well with TC also. These findings highlight the multi-dimensional nature of living with TC and the transformative role of spirituality in the lives of TC patients. The findings can inform future research, healthcare practice and policy in health and psycho-oncology.