Pain exacerbations are essential clinical problem in cancer patients, which effects in significant deterioration of quality of life, as well as necessity of use of rescue drugs and much higher costs of treatment. This paper reflects to commonly used definitions of episodic pain and breakthrough cancer pain. The aim of this article is simple presentation of management of pain exacerbations and available options of therapy. It is a synthesis of contemporary rules of management of pain exacerbations, based on current guidelines of the European scientific societies, and including the recent clinical data.