Introduction：Halo-vest is usually used temporary to immobilize the cervical spine after surgery or injury. We experienced a good pain relief by halo-vest attachment in one patient with metastatic tumors of cervical spine. Case：A 76-year-old male patient was diagnosed with cervical spine metastases during chemotherapy treatment for lymph node recurrence 7 years after the first surgery for his esophageal cancer. His neck and back pain did not improve even after pain management by analgesics and radiotherapy. He also experienced strong side effects due to opioid treatment. Eventually, he became immobile. Halo-vest was applied solely for the purpose of pain control. Since then, his pain diminished, opioid stopped and his gait recovered. After moving to a hospital close to his home, he was discharged from the hospital. He could stay at home without a severe complication and opioids for 2 months. Discussion：Fixation of the cervical spine with halo-vest might be a good procedure for pain relief in patients with cervical spine metastases. However, since it could also be a stressful treatment and might cause a severe complication, thorough discussion for the use of a halo-vest is mandatory with the patient, family, and orthopedists.

  In our hospital the palliative care committee has been held once a month since 2000. In 2007, a total of 1,583 cancer patients were admitted to our hospital orreceived medical care at home. The average length of hospital stay was 24 days. Of the total number of patients, 88.4% was informed that they had cancer. In the latter half of the year it increased to 92.6% because the palliative caretakers gave doctors accurate information on patients' psychology and social background. In October 2007 a questionnaire survey was conducted on those who visited our palliative care section on the occasion of the hospital festival. A total of 46 responded to our survey about the knowledge of palliative care, physician's precise explanation about the illness, image of opioids, desirable place of death and so on. Twenty-eight respondents (60.9%) did not know anything about palliative care. Forty-four (95.7%) wanted precise explanation of cancer. Thirty-four (73.9%) said they had had a night image of opioids after reading the panel. Twenty-eight (60.9%) responded they would rather stay at home until death. We should give healthy people more information about palliative care and opioids.