Pain syndrome is observed in most patients with cancer at various stages of the tumor process and treatment. Pain can be associated with stimulation of pain receptors (nociceptive pain) or damage to the sensory nerve fibers (neuropathic pain). Classical analgesics (NSAIDs, opioid analgesics) are effective against nociceptive pain, whereas gabapentinoids and tricyclic antidepressants are effective in the treatment of neuropathic pain syndrome. Approximately every five patients have a mixed pain syndrome, which requires the use of drugs from different groups for complete pain control. Tapentadol is both a µ-opioid receptor agonist and a norepinephrine reuptake inhibitor, allowing it to act on both types of pain. The favorable safety profile makes tapentadol a good option for long-term therapy of chronic cancer pain syndrome. The described clinical example of long-term (more than 2-year), effective use of tapentadol in a patient with mixed cancer pain syndrome during antitumor treatment confirms this fact.