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In the United States and throughout the world, cancer pain is underrecognized and undertreated. Despite advances in the field of pain management, pain control remains a significant problem, primarily because clinicians fail to adequately assess patients and provide appropriate treatment. Certain features of patients with head and neck cancer make pain relief more difficult, but the application of clinical practice guidelines for cancer pain that emphasize systemic pharmacologic therapy has been shown to provide relief in 80% to 90% of these patients. In patients who do not obtain relief with conventional approaches, specialized anesthetic techniques, including nerve blocks and intraspinal drug infusions, may be beneficial.