Backgrounds: Pain appears in more than 1/3 of patients in early stageof cancer, 70% patients in advanced stage and almost in 90% patients in terminál stage. Most of tne patients with malignant illnesses statě that tne fear of severe pain presents tne major share of distress caused by cancer rather than the illness itself. Design and Subjects: Open-label prospective evaluation regarding the management of severe chronic pain requiring the use of strong opioids. Proving efficacy and safety of transdermal fentanyl (trade name Durogesic). The focus was upon so called Quality of Life factors, such as analgesia, quality of sleep and adverse effects occurrence. Totally, 466 patients suffering from pain caused by malignant disease were included with practically equal proportion of male and female participants. Methods and Results: Among this set of patients, nociceptive pain prevaileď, however the share of neuropathic pain was inconsiderable, as well. The intensity of pain was evaluated using a 10-point analgesia scale (VAS scale - Visual Analog Scale; 0 to 10), whereas additional parameters were mostly assessed on a 5-point scale. The most pronounced influence was seen in pain intensity, the main evaluated factor, which decreased by 50%, i.e. score less than 3 on VAS, during 2 month evaluation. Clear improvements in sleep and normál daily as well as family activities were recorded. No differences in profile and incidence of adverse effects háve been seen compared to the manufactureťs specification, i.e. their less frequent occurrence compared to other opioid products. Conclusions: Our research has confirmed a generally known fact that Durogesic is an outstanding analgesic. There are markedly less adverse effects when compared with other pharmaceutical forms of opioid preparations. For this reason, an overwhelming majority of patients from our group preferred this type of treatment. Durogesic is a suitable remedy to treat severe chronic cancer related pain.

        Key words: pain, sleep, fentanyl, Durogesic