Analgesic therapy is a basic part of palliative care in a cancer clinic. Pain syndromes in cancer are noted for extreme severity and often a poor prognosis that is why the central place in their pharmacotherapy is assigned to opioid analgesics everywhere although the therapy police for non-cancer pain takes into account its pathogenesis and type. The authors present the data of their investigations and the results of an analogous foreign trial, which leads to the conclusion that the stepwise increment in opioid therapy for neuropathic pain is groundless as this increases the rate of adverse reactions from therapy and considerably lowers quality of life in patients. In this case, pathogenetic therapy based on a combination of current anticonvulsants and weak opioid analgesics is most expedient.