Moral distress is an important challenge in nursing care for patients with cancer, particularly during advanced stages of disease and end-of-life care. Situations such as conflicts between patients’ and families’ preferences, disagreements among healthcare team members, resource limitations, continuation of non-beneficial treatments, uncertainty regarding goals of care, and difficulties in end-of-life decision-making are important circumstances associated with moral distress. Existing evidence indicates that moral distress among oncology nurses is associated with individual, professional, and organizational factors and may have consequences such as psychological distress, burnout, reduced quality of care, and intention to leave the profession. The ethical climate of healthcare organizations also plays an important role in shaping this experience, as supportive work environments that facilitate ethical dialogue and responsible decision-making are associated with lower levels of moral distress. Therefore, addressing moral distress should not be limited to strengthening individual nurses’ knowledge and skills but should also consider the conditions under which care is provided, team communication, and organizational structures. Access to clinical ethics consultation, regular opportunities for ethical discussion and reflection, training in communication and ethical decision-making, strengthened collaboration among healthcare team members, and supportive mechanisms for nurses may help reduce moral distress. Strengthening nurses’ moral resilience may also enhance their capacity to cope with ethically challenging situations. Overall, systematically identifying situations that contribute to moral distress and providing individual, team-based, and organizational support are essential for protecting nurses’ professional well-being and promoting ethically responsive, high-quality care for patients with cancer.