ABSTRACT Background: Pain continues to be a very prevalent symptom too often undertreated in cancer patients at all stages of their disease.  It is difficult to manage, and patients often show a poor or limited response to analgesic medications or experience intolerable adverse effects. Objective: The aim of the current work was to compare the effect of adding calcitonin to methylprednisolone versus methylprednisolone alone to local anesthetic in erector spinae plane block for patient suffering from thoracic cancer pain. Patients and methods: A double-blind study was conducted from November 2019 until November 2020 at Outpatient Pain Clinic, Oncology Center, Mansoura University (OCMU). This study included thirty patients of both sexes and range of ages (30-70 years), with a history of chronic thoracic cancer pain ≥ 4 on a visual analogue scale (VAS) of 0 – 10 and Chronic pain for at least 3 months prior to study entry. Patients were divided into ywo groups, 15 each, Group (I) (methylprednisolone group) and Group (II) (calcitonin group). Results: Any post block events like nausea, vomiting, respiratory depression (when SpO2 less than 92%) and pneumothorax were recorded.  Consumption of analgesics (tramadol 1 – 1.5 mg / kg when needed) during first three months post procedure was measured. Patients of both groups gained benefits from the techniques. The two groups showed decline in the VAS scores and the total tramadol consumption. Calcitonin group has more prolonged duration of pain relief, significant reduction in pain scores, lower tramadol requirements, tolerable side effects. Conclusion: Patients received calcitonin added to methylprednisolone and local anesthetics had significant reduction in pain scores, more prolonged duration of pain relief, less rescue analgesia (tramadol) consumed and was more satisfied with the treatment modality as compared to methylprednisolone and local anesthetics treated patients in 3 months follow up periods.