Background:COVID-19 pandemic has afflicted cancer patients on various fronts including spiritual domain. The case series tries to highlight the spiritual beliefs and challenges faced by cancer patients and the transformation which has occurred during pandemic. Methods: Thirty consecutive cancer patients who attended outpatient clinic of cancer pain and palliative department were assessed on spiritual front through nine questions and on the basis of which their perception about spirituality,

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... th problems, role of pandemic in transformation of spiritual beliefs and their coping mechanisms were analyzed. Results: Most respondents related spirituality to almighty. Half of the cases blamed karma, fate and God for their suffering. Signs of transformation in spiritual credence during pandemic was evident in the form that majority could not attend their places of worship, were having lack of spiritual clarity and developed feeling of fatalism. For coping with the stress and anxiety majority resorted to path of prayer and chanting at home, with few having belief in helping out others and participating in spiritual community sessions to overcome their problems in life. Conclusion: Spiritual domain of the patients is often an overlooked component by the clinicians during their examination. But maintaining a good spiritual health is as important as physical health for an overall better outcome in cancer patients and should be catered for providing a holistic care.