Experts say it may be time to stop ringing the ‘cancer bell’

Cancer patients often ring a ceremonial bell to celebrate the end of their radiation treatment or chemotherapy. The gesture is meant to signal joy, but it may be producing the opposite effect at healthcare institutions across the country.

A team of researchers recently polled more than 200 cancer patients to gauge their feelings about this ritual, which occurs in 82% of National Cancer Institute-designated centers. Lead investigator Patrick Williams, MD, was “surprised” to see his expectations defied.

Half of the study group rang the bell at the end of their treatment while the other half did not. Those who opted to take part actually remembered treatment as more stressful than their counterparts who refused, according to a study published recently in the International Journal of Radiation Oncology.

“We expected the bell to improve the memory of treatment distress, but in fact, the opposite occurred,” Williams, a radiation oncologist with the University of Southern California, Los Angeles, at the time of the study, said in a Jan. 22 announcement. “Ringing the bell actually made the memory of treatment worse, and those memories grew even more pronounced as time passed.”

He listed several possible reasons for the survey results. Sounding the bell can create a “flashbulb event” for cancer survivors, locking that moment into their brains. However, rather than engraining the joy of beating cancer, it can often lock in the stress of suffering through the disease, Williams said. It also can create false hope for those who might suffer a recurrence, or upset nearby patients who are still struggling with treatment.

The team urged providers to explore other means of celebration that might not have the same negative consequences.

“The important thing is not to stir emotions at the end of treatment,” Williams said in the announcement. “Some people have small gifts or certificates of completion to mark the end. I think these are okay because they do not arouse emotions in the same way that ringing a bell to a crowd of applauding people does.”

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

Around the web

The patient, who was being cared for in the ICU, was not accompanied or monitored by nursing staff during his exam, despite being sedated.

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.