Cancer “Victory Bell” May Cause Treatment-Related Distress

Ringing the “victory bell” to signal the end of cancer treatment is considered a rite of passage for survivors, associated with successful treatment. However, this ceremony is controversial, with some patient advocates suggesting it may cause feelings of anger or depression in patients with metastatic disease who require chronic treatment. Now the first-ever prospective controlled clinical trial shows that these feelings of distress may also occur in patients who have completed their treatment, resulting in negative perceptions of treatment experiences.  The study evaluated post-treatment distress and perception in 163 patients concluding radiation treatment. 

The study found that overall distress scores, as measured on an 11-point rating scale, were significantly higher among patients ringing the bell at the conclusion of treatment compared to those who did not ring the bell (5.6 vs 4.7; P = .045). Other factors associated with increased distress in bell-ringers compared to non-ringers included age less than 60 years (P = .025), non-prostate or genitourinary cancers (P = .002), and cancer initially diagnosed based on symptoms (P = .02). On follow-up post-treatment (median about 100 days), distress scores increased more  for patients in the bell-ringing cohort compared to non-ringers (6.4 vs 5.1 P = .009).

The investigators concluded that ringing the victory bell worsens patient’s evaluation of distress from cancer treatment, and that this effect persists in the months following treatment. They suggest that clinics should reevaluate their use of victory bells and place less emphasis on these tools as an end to treatment. 

Read more about this article on Medscape Medical News.

Int J Radiat Oncol Biol Phys. 2019;105(2):247-253.
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