Purpose <p>Increased distress has been associated with impairment related to cancer treatment and with post-traumatic growth (PTG), but the influence of treatment-related impairment on PTG has not been explored. This study aimed to understand the lived experience of PTG for cancer survivors living with treatment-related impairment.</p> Methods <p>Hermeneutic phenomenology was used to develop a deep understanding of the lived experience of adult cancer survivors living with ongoing treatment-related impairment who had experienced self-perceived PTG following their cancer experience. Semi-structured individual interviews conducted with eight participants were transcribed, manually coded, and thematically analysed.</p> Results <p>This study demonstrated that people with ongoing treatment-related impairment can experience PTG through coping with cancer. PTG was both a coping process and an outcome of coping with adversity. Participants experienced growth outcomes in the domains of new possibilities, relating to others, personal strength, and appreciation of life. Participants first experienced a state of incongruence arising from the intrusion of cancer, which challenged their existing world view and self-concept. They reported using coping strategies to manage distress, enabling productive meaning making. A notable absence of distress about impairment was attributed to participants facing this later in their cancer trajectory when meaning making was well established, and their experience of impairment more readily assimilated.</p> Conclusion <p>The extent of PTG in cancer survivors may depend on the degree of incongruence they experience and their ability to accommodate these contradictions to develop new meaning. Further research is needed to understand how early or visible treatment-related impairment influences cancer survivors’ PTG.</p>