Most, if not all, cancer patients require care from community teams at some stage during their disease trajectory. For many of these patients, community nurses and General Practitioners are the main point of contact. Pain is reported by between 55-95% of patients with advanced or terminal disease. Optimal pain control positively impacts on the physical, emotional and functional well-being of the patient. Despite the existence of guidelines (WHO, 1996) (SIGN, 2000) and a wealth of literature on cancer pain management, half of all patients in Western countries still do not receive adequate pain relief. This article looks at the reasons behind this and provides community nurses with an overview of up-to-date information on pain pathophysiology and management, so that the control of cancer pain can be optimized in the community.