Alberta Cancer Foundation

A Joyful Noise

On any given day, the celebratory sound of a ringing bell can be heard throughout the basement radiology unit of the Cross Cancer Institute in Edmonton.

The tradition is called the Bell of Hope. Patients are invited to ring a bell to celebrate a significant milestone in their cancer journey — the completion of treatment.

“You see a change in patients [when they ring the bell]. Sometimes they’re a little bit timid when they pick it up … but generally by that last ring, they mean it,” says Ashley Ayume, medical radiation therapist at the Cross.

Ayume and her colleague Susan Mortensen, who also works as a medical radiation therapist at the Cross, brought the bell of hope initiative to the hospital about eight years ago. Ayume discovered the idea online while looking for inspiration from other cancer treatment centres. The pair wanted a way for patients, family and staff to publicly celebrate the milestone of finishing cancer treatment together.

“We’re giving them this amazing care while we’re here, but we don’t want them to just feel lost when we’re done. We wanted to start something for them. Something positive. Then we found the bell, and it just fit,” says Ayume. The ritual first began at the MD Anderson Cancer Center in Houston, Texas, in 1996. Patients there ring a large bell that’s attached to a wall. Next to the bell is a poem on a plaque that was written by cancer survivor Irve Le Moyne, a U.S. Naval officer who was one of the first patients to ring the bell. Ayume and Mortensen have included Le Moyne’s poem on plaques throughout the unit at the Cross, as well.

Ringing Out

Ring this bell
Three times well
Its toll to clearly say,
My treatment’s done
This course is run
And I am on my way
— Irve Le Moyne

At the Cross, portable bells, rather than one large one, seemed more practical to accommodate the unit’s high number of patients. The mismatched bells that live on the radiation unit sit on tables lining the long waiting room hallway. Patients can choose to ring a bell from the collection or bring their own from home. Some celebrate publicly in the hallway with friends, family and staff, and are met with applause. Others choose a more private bell ceremony in their treatment rooms. Some patients even ring the bell when their treatment begins as a way to acknowledge the start of their cancer journey.

Regardless of how it’s done, the bell brings courage for whatever step comes next.

“It’s finishing a chapter and starting a new chapter of survival,” says Mortensen. “It brings a smile to your day when you’re working and you can hear the bell ringing. It’s a small and simple way for patients to say how happy they are to get through their journey.”

Similar versions of the Bell of Hope ritual are practiced at cancer centres across the province, including the Tom Baker Cancer Centre. For patients, the ritual is especially important when the transition home can be fraught with anxiety over the unknowns ahead.

“You’ve got to hold on to every win you get. Finishing that day, it doesn’t matter what’s coming after, you celebrate it if you can,” says Ayume.

The sound of bells has an impact on those undergoing treatment, too. “When patients are having a rough day and need a light at the end of the tunnel, the bell can be it for them,” she says. “When they’re in the waiting room and see another patient ring the bell, they get to clap and be excited and know that their day is coming.”