Cancer-related pain is the most distressing symptom for cancer patients. Refractory pain due to inadequate opioid dosage clearly threatens both anti-neoplastic outcome and quality of life. Meanwhile, opioid-induced side effect remains a psychosocial burden throughout patients' terminal stage. To solve this dilemma, we propose that minimal invasive treatment could serve as a perfect remedy to help optimize opioid medications through shared decision-making (SDM). Unlike the traditional medical decision-making process, SDM is a powerful tool that delivers a most update patient-centered care from evidence-based medicine. This review discussed barriers and patient empowerment in cancer pain management and useful SDM options to help patients' adherence to minimal invasive procedure. In conclusion, SDM approach involves both patients and clinicians in decision-making about possible treatment options based on patients' preferences and best available evidence.