Cancer pain is a complex entity that is not only about physical pain but also refers to total pain, which affects the quality of life of patients and caregivers.The management of cancer pain has advanced due to the great needs of each of the patients with advanced cancer diseases, not only multiple pharmacological options are available, but also interventional management and non-pharmacological measures play an important role in the management of this pathology.The objective of this review is to describe the different analgesic strategies reported in the literature for patients with difficult-to-manage cancer pain