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Pain is more or less present on a permanent basis at a certain point in cancer progression, particularly during palliative care phases (in at least 70% of patients). The aim of this chapter is not to teach everything about pain but rather to define practical attitudes and reasoning. At least 90% of pain can be relieved.

Pain can be defined as an unpleasant personal sensorial and emotional experience associated with real, potential or feared tissue damage.

It is clear from this large definition that all pain, even if perfectly isolated and described, very rapidly involves affective, emotional, cognitive or behavioural components. Physical pain is most often completed by 'moral' pain or total pain.

The following domains are explored over the next pages:

Neural pathways in pain

Assessment of a painful patient

Cancer pain

Treatment principles

Therapeutic scales

Opioid rotation

Neuropathic pain