A pain may seem to resist all kinds of therapy without necessarily being absolutely refractory to treatment. The factors are discussed which may contribute to the "refractoriness" of a pain to therapy in the area of pain due to carcinoma, i.e. lack of understanding of modern pain concepts, inability to diagnose pain as due to conversion, failure to recognize the influence of the affects anxiety, hopelessness etc. on pain intensity, administration of analgesics in situations where another form of therapy would be indicated, e.g. plexus blockade, and insufficient knowledge of the effects, side effects, dosage and timing of the administration of mild analgesics, neuroleptics, antidepressives and narcotics.