Severe intractable pain with paresthesia and severe dyspnea produced by lung cancer involving both brachial plexuses, refractory to ordinary pharmacologic approaches, was managed by epidural morphine and bupivacaine administration with the continuous Baxter infusion system. Chest pain, which is somatic pain in character, was well managed with the epidural morphine and bupivacaine administrations. However paresthesia and tingling sensation of the hand and forearm were poorly controlled by epidural morphine, and were finally managed by bolus epidural injections of bupivacaine. Supportive therapy included epidural steroid injection and TENS, but the effect was not satisfactory. Severe dyspnea seemed to aggrevate cancer related pain.