In most (65-80%) cancer patients at an advanced stage of illness we find significant, invalidating symptoms of pain. Cancer pain is a complex pain (with a nociceptive, neuropathic and deafferentation component), which requires a multidisciplinary approach (surgery, radiochemotherapy, and pain therapy). Pain therapy has various pharmacological strategies at its disposal (opiates, anti-inflammatory and adjuvant drugs) together with modulation and neurodestructive techniques, which must be applied taking account of both the stage of the disease and the pain intensity. In elderly patients, a careful, tailored management of pharmacological therapy is required. In older age, personality disorders are also to be found (anxiety, depression, hypocondria and feeling of abandonment), which make therapy more complex and varied. Knowledge of these problems will, however, make it possible to control cancer pain in elderly patients to the best possible effect and improve the quality of life in the advanced and terminal stages.