“A day goes by, no matter, if you live it happily”: Coping and experiences of Asian Americans with metastatic cancer.

543 Background: Asian Americans face cancer as the leading cause of mortality, and managing distress related to advanced disease is a major concern. While the experiences of earlier stage Asian American cancer survivors are known, less is known about coping with metastatic cancer. This secondary qualitative analysis study aimed to understand the experiences of Chinese, Vietnamese, and Korean (CVK) American adults living with metastatic cancer. Methods: Semi-structured interviews were conducted in participants’ native languages (i.e., Mandarin or Cantonese, Korean, Vietnamese, English). Reflexive thematic analysis was used to construct themes answering the question: “What are the experiences of Asian Americans with metastatic cancer, and how do they cope?” Results: The sample included 69 adults with solid tumor metastatic cancer ( M age = 52.03, SD = 21.18) who identified as Chinese (52.17%), Korean (17.39%), and Vietnamese (30.43%) heritage. Preliminary themes are: (1) existing cultural beliefs influence appraisal and management of cancer, (2) need for connection without sacrificing one’s independence, (3) cancer impacts well-defined roles and duties, and (4) cultural virtues and beliefs promote resilience. Existing beliefs (e.g., cancer attributed to “karmic arrangement” or one’s “bad actions”) contributed to cancer-related stigma and keeping diagnoses private. Participants coped with distress through action-oriented means, such as problem-solving and maintaining family duties. Although interpersonal connection was desired, relational values, such as wanting to “save face” and reduce emotional burden on others, complicated garnering such support. Participants also described coping strategies rooted in cultural and religious virtues that helped promote a full acceptance of cancer, in order to move forward with gratitude, positivity, and creation of meaning with one’s time. Conclusions: This study elucidates the beliefs and values of CVK American metastatic cancer survivors and their ways of coping with metastatic cancer. Beliefs may contribute to distress but also promote resilience throughout the journey. Findings can inform healthcare providers’ conceptualizations of how social contexts influence the lives of Asian American metastatic cancer survivors.