We explored how people negotiate, and respond to, identity transitions following a diagnosis of pancreatic cancer. Interviews with 19 people with pancreatic cancer were analysed using thematic discourse analysis. While discursively negotiating two transitions, ‘moving from healthy to ill’ and ‘moving from active treatment to end-of-life care’, participants positioned themselves as ‘in control’, ‘optimistic’ and managing their health and illness. In the absence of other discourses or models of life post-cancer, many people draw on the promise of survival. Moving away from ‘survivorship’ may assist people with advanced cancer to make sense of their lives in a short timeframe.