The risk of developing cancer increases with age, and pain is one of the most common symptoms associated with cancer. Due to the frequent co-occurrence of other chronic diseases or ailments, the treatment of cancer pain in the elderly can be a challenge for specialists. The need for simultaneous use of many drugs and a high risk of their interaction means that in practice the choice of the appropriate analgesic cannot be accidental. Tapentadol is one of the drugs with a favourable pharmacokinetic profile. By combining in one molecule the μ opioid receptor agonist activity in the central nervous system and inhibiting noradrenaline reuptake in the descending anti-nociceptive system, it is highly effective in the treatment of moderate to severe cancer pain, also with a neuropathic component. Due to the low risk of drug interactions, tapentadol is a safe therapeutic option in patients with multiple diseases.