Should cancer centers ban the bell?

By Brian Casey, staff writer

January 24, 2020 -- Bells have become commonplace within oncology centers as a means to allow cancer patients to mark the end of their course of treatment. But is it time to ban the bell? A new study published in International Journal of Radiation Oncology, Biology, Physics suggests it might.

The tradition of ringing a bell after completing chemotherapy or radiation oncology treatments began in 1996 and is now commonplace at many oncology centers. In fact, previous research found that bells were in place at 51 of the 62 U.S. National Cancer Institute-designated cancer centers in the U.S.

But a backlash has been building against the bell. While completing treatment is a joyous moment for many cancer patients, many others within earshot of the celebrations still have a way to go -- and some may not complete their treatment at all before succumbing to the disease.

In the new study, radiation oncologist Dr. Patrick A. Williams led a team that surveyed 200 cancer patients for their opinions on ringing the bell. Half of those surveyed had participated in a bell-ringing celebration, while the other half did not (Int J Radiat Oncol Biol Phys, October 1, 2019, Vol. 105:2, pp. 247-253).

The researchers found that patients who rang the bell remembered their course of treatment as being more distressing than those who finished without ringing a bell. Williams believes that the bell-ringing ceremony creates a "flashbulb event" in a patient's life -- a vivid snapshot of their memories at the time.

And in many cases, those memories are not positive.

"Rather than locking in the good feelings that come with completing treatment ... ringing the bell appears to lock in the stressful feelings associated with being treated for cancer," Williams said in a press statement released by the American Society for Radiation Oncology.

Williams said he would like to replicate his study with a larger group of patients to see if the findings hold true with a broader audience. In the meantime, he suggested that many cancer centers continue alternatives to the bell-ringing ceremony, such as awarding a certificate at the end of treatment in a less public event.

The most important thing is to avoid stirring emotions at the end of a course of treatment.

"Many well-intended practices can lead to bad outcomes," he concluded. "We should study interventions before implementing them -- even ones that are well-intended."

Copyright © 2020

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