Nursing care of patients with advanced cancer is challenging because it touches many dimensions of a patient’s life. The study of spiritual pain is relatively new although potentially very important in understanding how to help patients with advanced cancer achieve a sense of well-being. The purpose of this pilot study was to increase scientific knowledge from the participants‟ perspectives about experiences of spiritual pain and physical pain, and identify correlates of well-being from the participants‟ own perspectives in the context of advanced cancer. Four research questions were examined in this study: 1. What is the relationship between physical pain and spiritual pain, as perceived by participants who have advanced cancer? 2. What is the relationship between spiritual pain and existential well-being, as perceived by participants who have advanced cancer? 3. What is the relationship between spiritual pain and physical pain in the context of the demographic and health-related variables of age, gender, years of education, and months since diagnosis? 4. What factors do participants with advanced cancer identify as important to their existential well-being? A descriptive correlational design was used to study the research questions in a convenience sample of 30 adult participants from an outpatient oncology clinic in Southern Arizona. Quantitative data were obtained through interviews using the Providence Saint Vincent Medical Center Pastoral staff’s Spiritual Pain Assessment Tool and Paloutzian and Ellison’s (2009) Existential Well-Being Scale, and a Physical Pain Rating scale along with a demographic and health-related form. Qualitative data were also obtained from the participants. Descriptive, correlational, and content analyses generated results of a significant relationship between Spiritual Pain and Existential Well-Being, and a non-significant relationship between Physical Pain and Spiritual Pain. The following themes (with the first three being most frequently mentioned) were identified as important to the participants‟ well-being during their experience of advanced cancer: Meaningful activity, family and friends, and spiritual aspects, followed by health/nutrition, symptom management, and finances. Results warrant continued research into spiritual pain as it relates to existential well-being in persons with advanced cancer