For a myriad of reasons, there are many aspects of pain that do not have the evidence base that we would wish. Pain in cancer patients is no different and too many treatments are based on anecdotal reports and the unshakable but untested ‘belief’ in the efficacy of the practitioners’ pharmacological tool. This edition of Current Opinion in Supportive and Palliative Care addresses the true evidence base of the often used pain treatments (but not always understood) of steroids and in a separate article, ketamine. These treatises discuss and debate the evidence and what this means for clinical practice. Dr Lim and colleagues (pp. 78–87) effectively condense the data and make an argument for the use of steroids but advise caution and underpins the necessity of careful individualized assessments and treatments. The evidence base for ketamine is overrepresented by noncontrolled trials but Drs Jonkman, van de Donk, and Dahan (pp. 88–92) reexamine and give a fresh oversight of the existing data. Importantly, the presentation of the ‘facts’ in these two articles can let the reader contemplate their own practice.