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Views And Reviews

It’s time to call time on the “end of treatment” bell

BMJ 2019; 365 doi: (Published 18 June 2019) Cite this as: BMJ 2019;365:l4236

Re: It’s time to call time on the “end of treatment” bell

Thank you for sharing your story, Jo. I have thought about this for a long time and spoken to several friends who have been through breast cancer, some surviving and being rung out and others not faring so well and being deeply distressed by hearing the bell being rung.

My personal opinion is that of course it is wonderful to celebrate the end of a treatment journey for patients, but there are likely to be those in the room who feel deeply distressed by the fact that firstly they are not "cured", and worse then feel terrible for feeling jealous of the person who has, as after all they have also had to battle cancer. Patients for whom the bell is rung are often also mindful of those who are in the room who will not have this experience, and this is also distressing/embarrassing in some way.

How is it OK to do something that we know is distressing some of our most vulnerable patients, even if it is giving something positive to another? This seems entirely not sensible to me. It may be that we need to look at another way, but personally I'm not a fan.

Competing interests: No competing interests

24 June 2019
Sonia Bathla
Breast surgeon
St helens and knowsley hospital