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From Jefferson Medical College, where Dr Pharo is assistant professor of anesthesiology and Dr Zhou is assistant professor of physical medicine and rehabilitation and anesthesiology, and from the Jefferson Pain Center, where Dr Pharo is acting director and an attending physician, and Dr Zhou is an attending physician.

Address correspondence to Gregory H. Pharo, DO, Jefferson Pain Center, 834 Chestnut St, Suite T-150, Philadelphia, PA 19107-5127. E-mail:gregory.pharo{at}jefferson.edu

Cancer remains the second most common cause of death in the United States despite advances in prevention, early detection, and newer treatment protocols. Pain continues to be the most feared complication of this diagnosis. Numerous studies have shown that when the World Health Organization treatment guidelines are followed, 90% of patients are pain-free. Although evidence is convincing that opioids are effective in the treatment of patients with cancer pain, reluctance to use them continues. Barriers to opioid use are multifactorial, but with education of healthcare providers and patients, treatment to manage pain will be more effective.