From the litterature we learn that social workers in health care are exposed to different stressors connected to the risk for the development of burnout or traumatization. However, there is a lack of studies that focuses on the social workers' own narratives on the burdensome, but also the rewarding aspects, of social work in health care. This study focuses on social work in oncology. Thematically structured qualitative interviews were conducted in a narrative form with 20 oncology social workers, half of whom were less experienced and half of whom were more experienced and with additional training in psychotherapy. The interviews focused on 'pros and cons of practicing social work' and the results were categorized by means of the similarities-differences technique. The burdensome cons concerned 'Organizational and professional barriers' and 'Demanding cases', with the latter divided into 'Impasse because of hopelessness' and 'Impasse because of helpnessness'. The rewarding pros categories all concerned meaningfulness including 'Organizational meaningfulness', 'Meaningfulness from giving', 'Meaningfulness from receiving', and 'Meaningfulness from personal development'. Our findings indicate that the burdensome and rewarding aspects are two sides of the same coin. They are interconnected in the sense that the strain and challenge of being in situations of psychological despair also imply emotional satisfaction due to an experience of meaningfulness.