Intrathecal analgesia is being used more frequently for patients with cancer pain unresponsive to regular treatments. In this case patient controlled intrathecal analgesia was used in a setting where the patient‘s pain was severe and unrelenting despite maximum tolerated doses of numerous analgesics, radiotherapy and nerve blocks. With the addition of the MyPTM device the patient‘s symptoms were markedly improved and as a result some baseline analgesia could be reduced. Though the intervention was relatively successful it did result in bothersome side effects and also brought with it new and challenging difficulties in relation to opioid management for us, the treating team to overcome.