A subcutaneous tunnelling and fixation of the catheter, bacterial filters, minimum changes of tubings, weekly exit site care, site protection, and monitoring for any signs of infection are suggested for advanced cancer patients. Areas still needing clarification include the optimum use of spinal adjuvants, the appropriate spinal morphine-bupivacaine ratio, methods to improve spinal opioid responsiveness, and long-term catheter management during home-care programs.