Wan Mun Chian, Azmawaty Mohamad Nor
Cancer survivorship frequently involves confrontation with mortality, yet qualitative findings on meaning-making and existential experiences remain fragmented. This PRISMA 2020-guided systematic review synthesized qualitative evidence on meaning-making among adult cancer survivors across Scopus, Web of Science, MEDLINE, and the Psychology & Behavioral Science Collection (final search: 25 November 2025). Twenty-eight qualitative studies were included and synthesized using thematic synthesis, with confidence assessed via GRADE-CERQual. Five themes were identified: confrontation with mortality and existential shock; existential suffering and biographical disruption; meaning reconstruction and reorientation; transcendence, spirituality, and faith-based meaning; and psychological adaptation, resilience, and growth. Across diverse cultural contexts, cancer survivorship consistently involved mortality awareness and existential destabilization, followed by efforts to restore coherence and purpose. Spirituality, self-transcendence, and resilience emerged as prominent coping pathways. These findings support meaning-centered and existentially informed psychosocial care with culturally sensitive spiritual resources.