Opioid-users cancer patients are a challenge in the perioperative setting given the high prevalence of chronic pain along with multiple underlying pathologies. In addition, the anesthesiologist and the healthcare team should consider factors specific to these patients and how to prevent these patients from suffering uncontrolled pain, relying on the anaesthetist to plan a multimodal analgesia strategy with an emphasis on regional anesthesia, in addition to the adjustment and conversion of opioid doses. Objective: Mentioning pain mechanisms in cancer, understanding how to address pain, planning opioid management and other strategies for proper control of perioperative pain. Methods: A review of the literature was carried out in the databases of MEDLINE/Pubmed, Google Scholar and Science Direct. It included articles in English and Spanish, published between 2000 and 2023. Conclusion: To an adequate management of opioid-users cancer patients is required to know how to deal with chronic pain, its mechanisms, as well as to know managing opioids and its adverse effects.