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ABSTRACTCancer creates fear and existential questionings which can result in a change of spirituality. Spirituality as a coping process can engender positive transformations (spiritual growth) as well as negative ones (spiritual decline). Although previous studies indicated that spiritual transformations are directly linked to the emotional component of subjective well-being, we do not know if they are related to its cognitive aspect. We first examined whether the link between spiritual growth and life satisfaction is mediated by post-traumatic growth and then moderated by time since diagnosis. Second, we tested spiritual decline as a predictor of life satisfaction, with negative affective state as a mediator of the relation between spiritual decline and life satisfaction. Eighty-seven melanoma patients were assessed about spiritual transformations and post-traumatic growth since diagnosis, positive and negative affective states, and life satisfaction. Relevant background and cancer-related variables were also measured. The association between spiritual growth and increased life satisfaction was mediated by post-traumatic growth and moderated by time since diagnosis. Results showed that life satisfaction increased through this pathway about two years after the diagnosis of melanoma. Additional results further showed that spiritual decline was not directly related to life satisfaction, but decreased it through negative affective state. Our findings highlight that the onset of melanoma creates some spiritual transformations which have to be supported in hospital.