Purpose of review Cancer incidence increases worldwide and thus more patients will suffer from cancer pain. As cancer pain severely affects quality of life, the decrease of pain should be of high priority for every clinician. In the last decade, attention for cancer pain and for its treatment has increased, and new pharmacological based treatment options became available. This gave reason to hypothesize a decrease in pain prevalence in cancer patients over the last decade. Recent findings Despite increased attention to cancer pain, pain prevalence in cancer patients has not significantly changed over the last decade as compared to the four decades before. This absence of change might be because of comorbidities cancer patients have, but also to undertreatment of pain, because of a lack of knowledge and pain measurement. Other factors underlying this absence of change are the use of incorrect coanalgesics in the case of treatment of neuropathic pain, as well as the present absence of potent analgesics with little side effects. Summary Consistent screening of pain in cancer patients and consequent correct treatment of pain might result in an impressive decrease in cancer pain. For further reduction of pain, new pharmacological analgesics need to be developed.