- Prolonged suffering from pain can affect quality of life to the point where patients lose desire to live. The attitude towards pain management in cancer patients has changed over the last two decades. The principles of treatment are based on prescribing analgetics while individually adapting medications and dosage according to the level of pain. Use of existing guidelines may relieve pain symptoms in 90% of patients. We evaluate knowledge, attitudes and skills of family physicians in Israel with regard to treatment of pain in cancer patients. The study included 123 family medicine residents and specialists from 3 different regions in Israel (Negev, Emek-Izrael, Jerusalem) who filled a self-reply, structured questionnaire. The response rate was 68%. The majority of physicians were residents in family medicine (55%) with work experience of 4-10 years, whose average age was 38.5 +/- 5.5 years. The majority of the study population: believe that treatment of pain in cancer patients is their responsibility (57%); do not believe that strong opioids cause addiction while it is thought that there is a moderate to high risk of addiction; feel comfortable prescribing opioids and are aware that opioids should be prescribed as needed without restriction. However, 25% will prescribe opioids "as needed" to a certain limit, and 30% will prescribe opioids only with a recommendation from the oncologist; most feel lack of knowledge in the areas of pain evaluation, opioid treatment, and managing side-effects of opioid treatment and feel a need for additional knowledge of opioid use. The treatment of cancer patients and their families is an important and serious challenge facing the family physician. The teaching of the proper tools will assist the future generation of family physicians in facing this challenge.