The cancer journey often involves a series of treatments, medical appointments, and emotional challenges. Throughout this demanding process, patients and their care teams look for significant milestones to mark progress and celebrate resilience. Among these, the tradition of ringing a bell has emerged as a widely recognized and deeply resonant symbol of hope and accomplishment within cancer treatment centers. It offers collective recognition for the patient’s perseverance and their support teams.
The Cancer Bell Tradition
The “cancer bell” is a ceremonial fixture in many hospitals and treatment centers, signifying the completion of a major phase of cancer therapy. This tradition began in 1996 at MD Anderson Cancer Center in Houston, Texas. It was inspired by U.S. Navy Rear Admiral Irve Le Moyne, a patient who, upon completing radiation, rang a brass bell, adapting a naval custom for a task well done.
The practice spread, with cancer centers nationwide adopting the ritual to celebrate the end of radiation or chemotherapy. For patients, families, and healthcare providers, the bell’s chime represents triumph, emotional release, and a transition from active treatment. It serves as a powerful symbol of overcoming hardship and a beacon of hope for others still undergoing treatment.
Understanding Remission and “No Evidence of Disease”
While ringing the bell is a moment of celebration, it is important to understand what this milestone medically represents. Oncologists use specific terms to describe a patient’s status after treatment, which often differ from the common understanding of “cancer-free.” The terms “remission” and “no evidence of disease” (NED) are frequently used.
Remission means cancer signs and symptoms have decreased or disappeared. This can be partial remission (cancer shrunk but not vanished) or complete remission (all detectable signs gone based on diagnostic tests like scans, blood work, or biopsies). Even in complete remission, microscopic cancer cells might still exist in the body at levels too low for current tests to detect.
“No Evidence of Disease” (NED) is often used interchangeably with complete remission, signifying no cancer can be found using current diagnostic methods. Achieving NED is a promising sign that treatment was effective, but it does not guarantee the cancer will never return. Oncologists rarely use “cured” because it implies cancer is permanently gone and will never recur. The possibility of undetected cancer cells or future recurrence, even years later, means absolute certainty is difficult to achieve.
The Ongoing Cancer Journey
Ringing the bell marks the end of a specific treatment phase, but the cancer journey continues with ongoing vigilance and health management. After treatment, regular follow-up appointments monitor for any signs of recurrence and manage potential long-term side effects. Appointments may include physical examinations, blood tests, and imaging scans, with frequency depending on cancer type, treatment received, and individual needs.
Patients may also receive a survivorship care plan, a detailed document summarizing their cancer diagnosis and treatment. This plan outlines a schedule for future check-ups and screenings, lists potential late effects of treatment, and provides recommendations for overall health. Managing long-term side effects, such as fatigue, neuropathy, or organ issues, is an important aspect of post-treatment care. The focus shifts to living well, which may involve lifestyle adjustments, psychological support, and continued communication with a multidisciplinary healthcare team.