The primary goal of this study was to describe well-being and its correlates in long-term cancer survivors who had exceeded their life expectancies (‘exceptional survivors’ (ES)) and to identify ways in which exceptional survivors differed from cancer survivors with much better prognoses (‘control survivors’ (CS)). Survivors were identified through a population-based tumor registry, and ES (n = 160) were matched to CS (n = 160) on age, ethnicity, site of disease, and time since diagnosis. Data were collected through in person interviews and self-administered questionnaires. Outcomes included quality of life, depression, and stress. Predictors included demographics, clinical variables and psychological predictors (sense of coherence, optimism, and resiliency). The findings led to several clear conclusions: (1) cancer survivors are doing well, in comparison to well-being in control populations; (2) cancer survivors exhibit higher levels of sense of coherence and resilience, but not optimism, than control populations; (3) psychological variables explain considerable variance in well-being; and (4) there are few differences between exceptional and control survivors. We conclude that objective disease state is not as important to cancer survivor well-being as personal attributes, and that a cancer diagnosis has such frightening implications that all survivors consider their recovery to be ‘exceptional.’. Copyright © 2004 John Wiley & Sons, Ltd.