Background <p>The incidence of cancer in young adults has been on the rise, with many cases being diagnosed at advanced stages due to the absence of early symptoms. Individuals aged 18 to 39, facing a diagnosis of advanced cancer, often experience disruptions during critical phases of their personal and professional development, including career advancement, relationship building, and family planning. The profound psychological impact of cancer during this formative period frequently leads to a loss of purpose, severely compromising their spiritual health.</p> Objective <p>To investigate the spiritual coping experiences of young adults with advanced cancer.</p> Methods <p>This study was performed in a tertiary cancer hospital in mainland China. Fourteen young patients with advanced cancer were interviewed using semi-structured methods between June and August 2023. Data were analyzed using Giorgi’s analytical model.</p> Results <p>Analysis revealed five central themes: (1) focusing on the present, (2) pursuing inner peace, (3) deriving strength from external sources, (4) experiencing negative emotions, and (5) achieving spiritual transcendence.</p> Conclusion <p>Healthcare professionals should implement tailored interventions aimed at enhancing the spiritual coping capacity of young adults with advanced cancer. This approach should support patients in rediscovering life’s meaning while honoring their religious beliefs and cultural context with Chinese characteristics.</p>