The case is reported a patient with advanced sarcoma and multiple metastases to lungs and nodes, in whom short episodes of movement-related incident pain appeared, despite good control of basic pain. Transmucosal fentanyl sublingual tablets were applied with the intention of up to 4 doses a day. The patient increased the frequency of applications up to 6 per day on average, with good effect and tolerance. The ability to self-service in basic life activities returned as well. Taking these facts into consideration, such a treatment regime has been maintained as the optimal alternative, without increasing doses of basic analgesic.