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Searches of cancer databases have shown that the rate of noncompliance among elderly cancer patients is significantly higher than among younger patients. Using the concepts of Theoretical Sampling and Grounded Theory, we tried to identify the reasons why older breast cancer patients (>69 y) declined or accepted treatment recommendations of their gynecologist / oncologist. We found meaningfulness of therapy in the context of the individual living situation to be the core decision category. Patients did not question the professional authority of their doctors but made their decisions based on individual factors in their personal living situation (axial coding categories), with advanced age playing an important role. The consideration of this knowledge is important for the success of the medical therapy conversations. Although a study with a selected patient cohort, this study is a good example for the use of Theoretical Sampling and Grounded Theory in qualitative health research.

In neurology, paroxysmal syndromes are well-known, eg, as manifestations of multiple sclerosis. We report a patient with meningeal carcinomatosis, who presented with therapyrefractory nausea and vomiting. The clinical suspicion of a paroxysmal syndrome prompted a trial of carbamazepine, which resulted in complete cessation of the symptoms. In cancer patients with central nervous system (CNS) involvement and therapy-refractory symptoms with sudden onset, carbamazepine treatment should be considered.