Ringing the Ceremonial “Cancer Bell” Following Course of Treatment May Have Unintended Consequences on Patients

The ceremonial ringing of the bell that takes place at the end of a course of cancer treatment may cause more harm than good, according to a study which appeared in the International Journal of Radiation Oncology.

In this study, researchers looked at 200 patients with cancer -of which half rang the bell at the end of treatment and half of did not – and found that those who rang a bell remembered treatment as more distressful than those who finished without ringing a bell.

Cancer Bell Creates A ‘Flashbulb Event’

The outcome surprised the study’s lead investigator, Patrick A. Williams, MD, a radiation oncologist who led the study and said in a press release that: “We expected the bell to improve the memory of treatment distress. But in fact, the opposite occurred. Ringing the bell actually made the memory of treatment worse, and those memories grew even more pronounced as time passed.”

“We think this is because ringing the bell creates a ‘flashbulb event’ in a patient’s life – that is, a vivid snapshot of their memories from that time,” said Dr. Williams, explaining that events become more deeply embedded in our memories if emotions are aroused, due to connections in the brain between memory and emotion. “Rather than locking in the good feelings that come with completing treatment, however, ringing the bell appears to lock in the stressful feelings associated with being treated for cancer.”

“We can consider other avenues that would allow patients to celebrate reaching the end of their treatment, but without negatively reinforcing things that perhaps might best be forgotten,” agreed Richard Jennelle, MD, an associate professor of clinical radiation oncology at the Keck School and senior investigator on the study.

“Many well-intended practices can lead to bad outcomes,” concluded Dr. Williams. “We should study interventions before implementing them – even ones that are well-intended.”