<![CDATA[Managing comorbidities such as hypertension in geriatric cancer patients during end-of-life care presents a profound clinical and psychological dilemma, as treatment goals shift from strict physiological control to comfort. This study aimed to deeply explore the authentic lived experiences of older adults with advanced cancer in managing hypertension as a comorbidity during their end-of-life care phase. A qualitative descriptive phenomenological approach was conducted. Purposive sampling was used to recruit eight geriatric cancer patients (aged ≥60 years) with a documented history of comorbid hypertension who were currently receiving palliative or end-of-life care in East Java, Indonesia. Semi-structured, face-to-face in-depth interviews were carried out over a six-month period. The qualitative data were transcribed verbatim and analyzed systematically using Colaizzi’s seven-step phenomenological method to maintain structural rigor. The study successfully identified three main themes: (1) The Burden of Dual Illness: navigating the physical overlap of cancer pain and hypertensive distress; (2) The Treatment Dilemma: patient and family perceptions regarding the necessity of anti-hypertensive polypharmacy versus palliative comfort; and (3) Seeking a Peaceful Death: balancing existential acceptance with the daily stress of physiological monitoring. The study contributes an experiential perspective on how older adults negotiate cardiovascular management, treatment burden, autonomy, and psychospiritual priorities when hypertension coexists with advanced cancer at the end of life. These findings support flexible, individualized, comfort-oriented palliative nursing care that integrates symptom relief, medication review, shared decision-making, and patients’ cultural and spiritual values. ]]>
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