There is a bell hanging in cancer centers all across the country; you know the one, the brass bell mounted on the wall near the infusion suite. The bell patients are invited to ring when they finish treatment. The bell that draws applause from strangers. The bell that is supposed to symbolize victory, completion, triumph, closure.
The bell that everyone assumes is a good thing, but I keep wondering what would happen if we were honest about it.
What if we admitted that the bell may not just be harmful to those of us living with Stage IV Metastatic Breast Cancer (MBC), the people who will never be finished with treatment, but that it may actually be psychologically harmful to almost everyone who hears it?
What if the problem isn’t that some people don’t get to ring it?
What if the problem is the story the bell tells?
Because the bell tells a story and stories matter. The bell tells us that cancer treatment is a race with a finish line. It tells us there is an “after.” It tells us there is a moment when the hard part ends and normal life resumes. It tells us that suffering can be wrapped up neatly with a bow. It tells us that cancer is a chapter.
But for many people, even those diagnosed with early-stage disease, that story isn’t true.
The infusion may end, the radiation appointments may stop, the surgery scars may heal, but cancer doesn’t simply disappear from a person’s mind because a bell rang one afternoon. The fear doesn’t end. The uncertainty doesn’t end. The follow-up scans don’t end. The wondering doesn’t end. The hypervigilance doesn’t end.
For many people, the psychological burden actually intensifies when treatment ends.
During active treatment, there is structure. Appointments. Blood work. Scans. Doctors. Nurses. People watching closely. Then suddenly everyone celebrates, the bell rings, the confetti flies, the photos are posted.
And the patient goes home carrying a terrifying secret: “I don’t feel finished.”
Many survivors have described the period after treatment as one of the loneliest times in their cancer experience. The support system that surrounded them during treatment begins to fade. Friends assume everything is okay now. Coworkers assume life is back to normal. Family members desperately want to believe the crisis has passed.
Yet the patient is often left grappling with anxiety they never expected. Every ache becomes suspicious. Every cough becomes frightening. Every upcoming scan becomes a source of dread.
The bell didn’t create closure: it created expectations and expectations can become burdens.
The bell says, “Congratulations. You’re done.” But what happens when the person hearing those words doesn’t feel done? What happens when they still feel afraid? What happens when they still feel broken? What happens when they are grieving the body they used to have? What happens when treatment succeeded medically but permanently altered their life? What happens when everyone else wants a happy ending and they’re still trying to understand the story?
The bell leaves little room for complexity. It demands a single emotional response. Joy. Celebration. Relief. Gratitude. But cancer is rarely that simple. Most meaningful human experiences aren’t.
The truth is that people often hold contradictory emotions simultaneously. Relief and fear. Hope and grief. Celebration and loss. Joy and uncertainty. The bell doesn’t make room for any of that; it flattens a profoundly complicated experience into a single symbolic moment.
And then there are those of us sitting in the infusion chairs nearby. The people with stage IV disease. The people whose treatment plans don’t have end dates, except death. The people who know that next month, and likely next year, we will still be coming back (and are actually hoping like hell we’re still alive to do so).
For us, the harm is obvious. We hear the applause, we watch the smiles. We see the photographs and we are reminded that society has constructed cancer around a narrative that excludes us. A beginning. A battle. A victory. An ending other than death. Our lives don’t fit that script.
The more I think about it, the more I wonder whether the bell harms everyone because it reinforces a fantasy that cancer itself rarely respects. Cancer does not care about narratives. Cancer does not care about symbols. Cancer does not care about ceremonies. Cancer is uncertainty. Cancer is ambiguity. Cancer is learning to live with questions that may never receive answers.
The healthiest psychological adaptation often isn’t reaching certainty, it’s learning to tolerate uncertainty. Yet the bell promises certainty. It suggests a finish line where none may exist. And when reality inevitably reasserts itself, as reality tends to do, the emotional whiplash can be profound.
The recurrence. The suspicious scan. The new symptom. The unexpected phone call. Suddenly the bell becomes not a celebration but a ghost; a reminder of something that was supposed to mean more than it actually did.
I often think about what we could replace it with, not because people shouldn’t celebrate. Of course they should. Every completed treatment deserves recognition. Every difficult milestone deserves acknowledgment. Every patient deserves moments of joy, but perhaps there are ways to celebrate without creating a hierarchy of cancer experiences and without suggesting that some experiences are complete while others are perpetual. Without implying that treatment ending is the only meaningful milestone, because there are so many victories worth honoring.
Showing up for another infusion. Completing radiation. Getting through surgery. Receiving stable scan results. Managing side effects. Returning to work. Attending a child’s graduation. Making it through another difficult week. Learning how to live with uncertainty. Finding laughter in impossible circumstances. Choosing hope despite not having guarantees.
Those are victories too, perhaps even greater ones, and perhaps what cancer patients need most is not a bell that announces an ending, perhaps what we need is acknowledgment that every person’s experience is different. That healing and treatment are not the same thing. That survivorship is not simplicity. That metastatic patients are not failures. That uncertainty is universal.
That courage takes many forms.
Most of all, we need a culture willing to tell the truth. The truth is that cancer changes people, sometimes permanently. The truth is that treatment ending and cancer ending are not synonymous. The truth is that life after cancer is often more complicated than the brochures suggest. The truth is that many people leave treatment carrying as many questions as answers.
And the truth is that no brass bell can adequately capture what it means to live through an experience that fundamentally reshapes your understanding of time, mortality, love, fear, and hope. The bell promises a neat ending; cancer rarely offers one. What it offers instead is something far messier and far more human: the opportunity to keep living despite uncertainty.
And that, unlike a bell, is a victory available to all of us.
As we start 2026 Breast Cancer Awareness Month, please be on the lookout for PinkWashing and mark your calendars for the #LightUpMBC live show on October 13th, the ONE day all October set aside for those of us living with MBC.
