A growing number of cancer patients are living longer with incurable disease. This paper describes strategies that patients use to cope with the uncertain trajectory of their disease. Twenty-seven patients with a prognosis of 12 months were recruited from the oncology and palliative care service at three metropolitan Sydney hospitals. A semi-structured face-to-face interview was conducted, which was audiotaped and transcribed verbatim. The patients coped with the uncertain trajectory of their disease through avoidance, maintaining a normal life, comparing themselves favourably with others in a similar situation and remaining positive. Participants indicated that they did not wish referral for psychological support. The implications of these findings and the influence of grief counselling are explored