We frame the work of living with cancer as one which is identity-altering. Interviews with a heterogeneous group of cancer patients of varying sites and stages were used to conceptualise the identity work as involving disrupted feelings of fit, renegotiating identity, and biographical work. Patient narratives reflect these categories depending on their stage of illness and their experiences in medical institutions.‘Identity work’ is used to describe the process of patients' evaluations of the meaning of their illness within the actual context of ongoing, organised social relationships, including the medical system. We discuss the implications for narrative analyses in the social sciences.