Category: Practical Stuff

Advent 2025: Refusing Good Cheer

(Title image: Photo by Nathan Dumlao on Unsplash)

If you’re following my Advent experience, you’ll know that I had a teensy bit of trouble getting into the swing of things as far as reenergizing my mindfulness practice was concerned. But as I mentioned in my last post, the trick was regular and frequent (3x an hour) reminders to stop, take a breath and return to the present.

This strategy worked so well that these thrice-hourly breaks opened the door for gratitude to seep in. The extra-deep breath slowed everything down and made it easier to notice how “okay” things were around me.

That’s a reminder that I think we all need. So innocently, in casual conversations, I mentioned to friends how I found this Advent practice to be particularly uplifting because it allowed me some time and space, even if only a sliver, to realize there was so much good stuff going on.

And, ok, since I had such a positive experience with my deep breath and gratitude, I (gently) encouraged others to try it.

Psst! It’s that gratitude thing again.
(Photo by Thiago Rocha on Unsplash)

Well, just like unsolicited advice is wont to do, I didn’t get the greatest reaction to what I felt was simply finding light when things feel dark. Many people that I know have worries and hardships and things-to-be-angry-about, and sometimes, when difficulties abound…let’s just say that there’s not a lot of enthusiasm for making yourself feel better.

[Note: I am not suggesting “everything is 100% awesome” toxic positivity! This is about finding little things to appreciate.]

I think it’s very human to resist gratitude at times, especially when you feel you’ve been wronged and might believe that letting go of hurt and anger is like “letting the other side win”, so to speak.

But it is interesting to ponder how we can stubbornly cling to feelings of hurt and agitation if we convince ourselves that making ourselves miserable is how we further our cause. As if nurturing your discontent makes you more focused in fighting for your way. But I’m not convinced that this is beneficial; all it does is increase your stress levels, which introduces physical and emotional repercussions.

Instead, in allowing ourselves to soften and appreciate the good around us, we can lift our spirits. By calming ourselves and creating space, we think more clearly, respond more appropriately and ultimately are more productive.

There’s a lot think about this week—I am amazed at the difference that one little breath timer has made, and I’m so grateful for it.

Advent 2025: Expectation vs. Reality

(Title image: Photo by Dayne Topkin on Unsplash)

Or, “if at first you don’t succeed…”

I had planned out my Advent to incorporate a return to peace through mindfulness after a particularly difficult year. It wasn’t supposed to be overly involved or unattainable.

As a matter of fact, I figured it would be simple to slide back into staying more present, particularly since we are heading into one of my favorite times of the year. Hourly check-ins, more dedicated meditation time, a concerted effort at staying present all day long and avoiding anxious reactivity—oh, the blissful calm that would flood my life!

Hmmm, this did not go according to plan.
(Photo by Alan Rodriguez on Unsplash)

Instead, none of that happened. I was still running up until bedtime when I’d scramble to meditate. Continuously forgot to set an hourly reminder to return to mindfulness. Found myself being yanked around emotionally. And I didn’t even unpack any of the remaining moving boxes that are sitting around the new apartment.

An entire week of Advent was gone and I felt like I frittered it away. I was expecting to feel a bit more grounded by now, but I’m not even getting a decent night’s sleep.

So, I sat down to take a look at where I ran off the road. And truthfully, I was never even on one.

I stated my intention for Advent in last week’s post…and then aimlessly wandered off into the woods.

This is a good reminder that mindfulness doesn’t happen on its own, no matter how long you’ve been practicing it. By its very definition, it requires attention.

Funny, in order to practice mindfulness, you kinda need to be mindful about it.

This time, I had a brilliant idea: why not actually DO the thing that I planned to do?
(Photo: @FranticShanti)

Enough belly-aching. I brushed myself off, hiked up my pants and did the following: I set a timer. This could have been any sort of timer, but I used the Plum Village smartphone app’s “Bell of Mindfulness” timer, set to ring (well, “bong” actually) once every 20 minutes from 8am to 8am.

It’s a low, soulful tone that rumbles through whatever else I’m doing, while at the same time not sounding intrusive.

When I hear the “bong”, I take a deep breath and notice what that feels like. Quite often, that breath turns into a deep sigh and I realize that my breath before was shallower. So I take a few more deep breaths.

That type of diaphragmatic breathing, into the belly, activates the parasympathetic (“rest and digest”) nervous system, and thereby the relaxation response.

Then I go back to my work until I hear the next “bong” and this process repeats.

By mid-afternoon, I found that I was much more aware of my breath and was breathing deeper during the interval between the bonging. And that was just the first day.

Ahhhh, this was a much better plan than my previous “no-plan” plan. Yes, I was bummed that I hadn’t implemented an actual plan a week ago, but here I am now and it’s working well.

The best part is, you can’t really “fall behind” on being mindful. Unlike where I am with my Advent cheese calendar…

Advent 2025: Turning Inward

(Title image: Photo by Waldemar Brandt on Unsplash)

Sunday, November 30 marks the start of Advent. While this is a time period associated with a Christian tradition that encompasses the four Sundays and intervening weeks preceding Christmas—and is considered a season of preparation—I believe that it’s a season that can be appreciated by all, regardless of religious beliefs.

Certainly, stores are very willing to cash in on Advent calendars, some of which are extremely elaborate and quite expensive. That’s a sad reminder that where there’s a tradition, there’s a way to make money off of it.

Yep, there’s an Advent calendar for that.
(Photo: @FranticShanti)

There are more mindful ways of treating this season. While I celebrate Advent every year, as I’ve gotten older, the way that I focus on this time of the year has changed.

It used to be common to “give something up” for Advent. As a child, it was generally sweets, so that when the Christmas holiday came around, we would enjoy desserts all the more.

However, there are more meaningful ways to spend the 3+ weeks prior to end-of-year holidays.

Instead of “giving up” something that I might simply go back to once the holidays hit, I use Advent to help me form new and important habits, or to reinforce practices that I might have allowed to slip.

This year year has been a challenging one for me. I found myself pushing meditation back to evening time, right before bed…and I’d often fall asleep before I was done.

With so many changes and stressors in my life, I have spent too much of the day running, exhausted and not paying attention to what my body and mind are feeling. So for this Advent season, I’ve decided to reacquaint the rest of my day with staying mindful and present.

We can all use a reminder to remain mindful throughout our day.
(Photo by Jakob Owens on Unsplash)

Therefore, my focus has turned inward. I am paying more attention to sensations in my hands and feet, starting with the physical aspects of making my morning coffee (decaf) and tea (matcha). I have set a reminder on my phone to check in at least once an hour to see where my body is in space, no matter where I am. When I do so, I consider how long it’s been since I stretched my limbs or had a drink of water. In doing so, I anchor myself in the present moment and remember that difficulties ebb and wane like the tides.

Yes, I still have a lot of take care of, and the last month brought some painful changes that I have to fully deal with. And I can’t truly “slow down” at work the way some might suggest. But mindfulness works with my schedule.

Staying present means that I can keep pace with my responsibilities instead of allow them to run roughshod over me, since it helps me avoid a sense of overwhelm. Yes, that requires discipline as my tendency is to allow myself to get swept up in the torrent of anxiety and busyness that is my life. But I remain conscious of the fact that I get done what I can, and that is enough.

For anyone who feels that this isn’t “religious” enough, I disagree. I find that experiencing the present moment may be one of the most sacred things that you can do. You honor the nature of the season by being a participant in it, not simply a passive passenger in the whoosh of activities that mindlessly steamroll us through the holidays in the New Year.

I wish you a joyous Advent season!

Breast Cancer: Finding Gratitude as a Cancer Patient

(Title image: Photo by Diego PH on Unsplash)

I’m not going to lie, gratitude can be difficult to navigate as a cancer patient.

When you’re mourning your diagnosis and trying to hold yourself together from the shock, the last thing you want is for some sunny person to tell you to think about everything you’re grateful for.

At such a time, it can be very difficult to think of anything. I, personally, felt a lot of anger, bitterness and even betrayal after I was told I had breast cancer. It wasn’t a great set of feelings to sink into, but that was my reality.

While I tried doing gratitude practices, in the beginning the process was miserable and felt “fake”. The whole notion of being grateful struck me as forced and required me to think about things I didn’t want to focus on.

Tough to be grateful? Make a list of what doesn’t suck.
(Photo by Hannah Olinger on Unsplash)

However, what helped me was making a list. It started out as a list of things about which I could say, “well, at least this didn’t happen” and slowly shifted to “well, this thing made my life easier”. It enabled me to find positives that I had otherwise overlooked.

I wasn’t grateful for getting cancer. But having bosses whose wives had survived breast cancer made it easier for them to understand what I was going through…and also to offer some useful advice (as did their wives).

I didn’t have the luxury of not working throughout treatment, but I was glad that a series of big projects had ended the previous year, so I didn’t have a huge workload waiting for me at the office. And while I really wished I could have had a full-time income, my part-time position meant that I had an easier time shifting my schedule to accommodate appointments and days off following infusions.

Additionally, it was fortunate that the region in which I live had a number of highly lauded cancer centers. And my cancer center offered free counseling by excellent therapists specifically trained to work with cancer patients.

It was also a plus that the summer during which I had my chemo infusions ended up being mild—luckily, since we didn’t have air conditioning—and my fear of enduring nausea through hot summer days never became a reality.

My list got longer and longer.

Opening the door to gratitude soothes the overwrought mind.
(Photo by Pedro Ramos on Unsplash)

So little by little, I started to pick through all the things that ended up better than they could have been. I didn’t call it “gratitude” at first because I was still bitter and refused to accept that there was anything to be grateful for. But the more things that came up that made me realize how much better the situation had turned out…the easier it was to finally come around to the idea that, even in the midst of the crappiest-thing-that-could-happen, there truly were things that I could l squeeze out a bit of gratitude for.

It took time. But when I loosened my grip on bitterness, I allowed in a swell of gratefulness, so much so that it was almost overwhelming how, if I had to get cancer, if it truly had to happen, there were so many things that had gone right. I started feeling so much better emotionally.

So my advice to anyone who wants to try out that “gratitude stuff” to see why it’s so great for your mental health: be gentle, start slowly and don’t tell anyone you’re doing it. This is a private practice for you. When you finally allow yourself to zero in on those little things that aren’t so bad or are kind of fortuitous given the situation, you may find that they buoy your spirits.

That’s all it takes. Not need to rush. Let the appreciation come to you.

Breast Cancer: Surviving the High Cost of Treatment

(Title image: Photo by Alexander Mils on Unsplash)

Since we are now in the Pink Season, otherwise known as Breast Cancer Awareness Month, in the midst of encouraging mammograms and regular clinical exams, it’s also useful to consider a very important barrier to obtaining cancer treatment and services in the United States: cost.

This is particularly distressing because breast cancer research has been very well-funded and treatments are quite effective for most forms of the disease, with great strides also having been made in understanding some of the most aggressive variants.

But according to a 2021 memo from the the American Cancer Society’s Cancer Action Network, 61% of (all) cancer patients describe paying for their treatment to be “somewhat or very difficult”.

It is striking that financial difficulty affects the majority of cancer patients. Obviously, the lower the family income, the greater the hardship, with 80% of patients having to “make financial sacrifices to cover their health care expenses, including 44% who’ve dipped into their savings, 36% who’ve gone into credit card debt to pay medical bills and nearly a quarter who say they did not schedule or cancelled an appointment or procedure because of cost.”

None of this will come as a surprise to you if you’ve ever had to pay for healthcare in the United States. Suffice it to say, we have a problem with affordability here.

Aside from the stressors of the disease and treatment side effects, many people have the added anxiety of not being able to afford the cost of cancer care.
(Photo by Woliul Hasan on Unsplash)

I was one of the very lucky ones in this regard, as my husband and I both work for non-profit research institutes with generous benefits. At the time of my diagnosis, we were enrolled in an employer sponsored PPO (Preferred Provider Organization) insurance plan with a per-person, out-of-pocket yearly maximum of $2000. When we initially signed up for the coverage, I thought the increased cost of the PPO was unnecessary as we were all quite healthy. However, after my diagnosis, I was struck by how blessed we were to even have this degree of health coverage as an option.

Clearly, my family is in the minority in our good fortune. We were able to avoid the financial fears and burdensome debt, even bankruptcy, that affect so many other cancer patients. Cancer care is devastatingly expensive, particularly for those with little to no insurance coverage, or insurance coverage with extremely high deductables.

What options do you have if you find yourself delaying care due to finances?

*Start with your cancer center’s social workers. They have experience in helping patients and survivors who are dealing with financial hardship and can point you in the right direction.
* Visit the Cancer Financial Assistance Coalition (CFAC) website, which has a database that you can search according to your cancer type and financial needs to find a list of charitable organizations that can offer support for your situation.
*For medicines that are not covered by insurance, pharmaceutical companies may offer deep discounts on their drugs. Reach out to them directly. They would rather sell you a heavily discounted medication than not make a sale at all.

Even when it seems that your luck has run out, there are still options available to ease your financial burden. Unfortunately, the healthcare system might not change anytime soon, but please know that supportive charities can to lend a hand as you make your way through the cancer maze.

Breast Cancer: Do You Know Your Risks?

(Title image: Photo by Michael Shannon on Unsplash)

Since we’re creeping up on October, commonly known here as the very pink Breast Cancer Awareness Month, I thought it might be a good time to post the most common risk factors for breast cancer…and then explain the problem with focusing on them.

For reference, I used the risk factor list posted on the U.S. Centers for Disease Control and Prevention (CDC) website. The CDC’s list focuses on women, as they are the ones at greatest risk of developing breast cancer; a shocking 1 in 8 women (~12%) will develop breast cancer at some point in their lives.

But on to the list. The CDC divides breast cancer risk factors into two categories: risk factors that you cannot change and risk factors that you can change.

The ones that you cannot change are the following:

Age – The older you are, the greater the risk, with the majority of cases occuring in women aged 50 and above. Last I checked aging was still a thing, so we’re all heading in this direction.

Genes – BRCA1 and BRCA2 mutations put you at significantly greater risk for breast and ovarian cancer. This is one family heirloom that you’re better off not inheriting.

Age at first menstruation and menopause – Starting periods before age 12 and menopause after age 55 exposes you to higher levels of circulating female hormones for a longer time. The longer you steep in hormones, the more chance of developing the cancer. This is a little unfair, I think, because estrogen also helps maintain muscle mass, bone density and skin elasticity which are all good things, but that’s how it goes.

Breast density – The denser the breast tissue, the higher the risk. Denser tissue also potentially makes it more difficult to detect tumors. Dense breast tissue is less fatty and more fibrous and glandular…and more likely to occur in women with lower bodyfat, which is ironic considering it’s also better to leaner (see below).

Find out your family history of cancer and explore your genes.
(Photo by Antonino Visalli on Unsplash)

Personal and family histories of cancer and other breast diseases – Having had previous breast cancer yourself or in a close family member (including ovarian cancer) may raise your risk. This is a great reason to make health a family affair and encourage everyone around you to do what they can to reduce their risks.

Early exposure to radiation therapy – Having had radiation treatments to the chest prior to age 30 may raise your risk of developing a tumor later on. This is a double-whammy: survive one cancer (like lymphoma) by going through treatment…and get smacked with breast cancer.

Diethylstilbestrol (DES) – If you were given DES (to reduce chances of miscarriage; no longer prescribed) or your mother took this drug when pregnant with you, it may have increased your breast cancer risk. Again, proof that life isn’t fair.

The risk factors that you have some control over:

Physical activity – Being sedentary is associated with higher risk. If you ever needed a wake-up call to get moving, this is it (and while you’re at it, have your family members join you).

Postmenopausal overweight or obesity – Being an older woman with a higher bodyfat percentage may increase your risk, so menopause is a great time to reevaluate your diet and consider why you’re eating what you’re eating—is it just out of habit? Boredom? Depression?

Hormone replacement therapy – Taking hormones post menopause for more than five years may increase the chances of developing breast cancer (see “Age at first menstruation and menopause” above). So unfortunately, hormone replacement treatment to help with menopausal symptoms may end up working against you.

Pregnancy history – Never having a full-term pregnancy, getting pregnant after age 30 or never breastfeeding may all affect your risk. To be fair, these can be more difficult to control and no one should ever feel guilty about any of them.

Rethink your drink.
(Photo by Bermix Studio on Unsplash)

Alcohol – Drinking alcohol increases your risk of developing breast cancer. If you are using alcohol as a socially-accepted means of self-medication, consider quitting and using money you’d otherwise spend on drinks to find yourself a good therapist.

There are of course other, perhaps less well-established risk factors, but the above give an idea of the wide variety of different factors involved.

Okay, so what if you can say that you’re in the clear with most of these factors? I certainly did. Based on my lifestyle, I figured that breast cancer was something that I’d never have to worry about.

And I had reason to think this way. According to the National Cancer Institute’s risk calculator, at the time of my diagnosis, I had a 1.3% chance of developing breast cancer within the next five years. That is a very low percentage! And yet, I developed a tumor.

Does that mean the calculator’s answer isn’t meaningful or that risk factors don’t matter? Not at all. It means that your risk percentage is only that, your calculated risk. Everyone would be well-served to live as healthy a life as they can, keeping in mind that having a number of risk factors doesn’t definitively mean that you will get breast cancer.

At the same time, no one should assume that a low risk means you won’t get cancer. It’s still very important to get screened regularly and see your doctor about any lumps that you find, because while you might not be able to prevent breast cancer despite your best efforts, catching your tumor at an early stage provides you with the greastest chances for a positive outcome.

Exercise and Cancer Cells: High-Intensity Exercise = High-Intensity Results [RESEARCH]

(Title image: Photo by Blocks Fletcher on Unsplash)

I am a huge proponent of exercise, both for prevention of cancer and its recurrence and in management of cancer treatment side effects, not to mention improving quality-of-life. Now a new study shows how even just one exercise session can have a powerful effect on cancer cells.

A randomized controlled trial conducted by researchers in Australia (Bettariga et al., 2025, Breast Cancer Res Treat) explored the effects of a single bout of vigorous activity (either weightlifting or interval training) on the production of anti-cancer myokines and investigated how blood drawn from study participants affected live cancer cells in the laboratory.

There has been a lot of research on the efficacy of exercise in reducing the risk of both developing cancer and preventing recurrence. However, this study focused exclusively on breast cancer survivors, which was important given that the physiology of survivors is affected by the treatments that they’ve gone through.

What was so gratifying to me was to see the significant effect of strenuous exercise. While the greatest benefit was seen from high-intensity interval training regarding its lethal effect on live breast cancer cells due to particularly high levels of a myokine called IL-6, the researchers stressed that strength training was likewise important as a cancer-fighting activity because building muscle through exercise also increased the amount of myokines circulating through the body.

The study participants engaged in strenuous exercise, but the program was created with noice exercisers in mind.
(Photo by Intenza Fitness on Unsplash)

It’s important to note that all thirty-two participants in this study were not exercising prior to joining the research group. Even so, they were able to tolerate the high intensity of the workouts. Keep in mind that “high intensity” is relative to the individual. That means strenuous exercise (for this study, reaching an effort level of at least a 7 or 8 on a scale of 1 to 10) will be different for a novice exerciser versus a highly-trained professional athlete.

So often, I encounter people who are willing to take a plethora of medications with considerable side effects, but roll their eyes when exercise is mentioned. Some people view physical activity as being only for those who are interested in looking a certain way or being mainly for those who have already reached a certain level of fitness.

Nothing could be further from the truth. Exercise is for everyone. We all start at different points; where exactly that is doesn’t matter. What does matter is that we are willing to exert enough energy to make a difference in our physiology and our well-being.

This is not “diet culture” or anything to do with body shaming. This is about doing what you can personally to increase your chances of a cancer-free life.

Survivors can talk to their healthcare team, show them this research and request that doctors lobby their insurance companies. Personal training, subsidized exercise equipment and gym memberships, fitness classes at cancer centers—all of these should be considered a critical part of cancer treatment and survivorship.

REFERENCES

Reader-Friendly Article:
Reynolds G (September 11, 2025) “A single exercise session may slow cancer cell growth, new study shows.” Washington Post. Free access via MSN: https://www.msn.com/en-us/health/other/a-single-exercise-session-may-slow-cancer-cell-growth-new-study-shows/ar-AA1Ml2oc?ocid=socialshare

Research Study:
Full publication
Bettariga F, Taaffe DR, Crespo-Garcia C, Clay TD, De Santi M, Baldelli G, Adhikari S, Gray ES, Galvão DA, Newton RU (2025) A single bout of resistance or high-intensity interval training increases anti-cancer myokines and suppresses cancer cell growth in vitro in survivors of breast cancer. Breast Cancer Res Treat, 213, 171-180. https://link.springer.com/article/10.1007/s10549-025-07772-w
PubMed Listing
https://pubmed.ncbi.nlm.nih.gov/40608178/

Favorite Calm Things: Kaiyukan Aquarium in Osaka

(Title image: Photo by Cristian Palmer on Unsplash)

It’s been quite a week. And that means another post with some of my favorite ways to bring calm into my life…

This time around I’m posting about a video instead of a livestream. It’s a 12-hour long YouTube video of the central tank at the Osaka Aquarium Kaiyukan in Osaka, Japan, and it is glorious.

The central tank is a massively huge aquarium, showcasing marine animals from the Pacific Rim. According to the Kaiyukan Aquarium Wikipedia page, the tank is 34 meters (112 feet) long, 9 meters (30 feet) deep and has a staggering capacity of 5,400 cubic meters (190,699 cubic feet) of water. Its enormous size enables it to house an impressive range of animals, including whale sharks!

The central tank at Kaiyukan Aquarium in Osaka, Japan.

As long as you don’t have a fear of ocean scenes, the blueness of the water is very soothing. It feels nurturing and safe.

The soundtrack itself of the video is a little surprising: it’s disarmingly upbeat and I would not have expected it to have a calming effect…but give it a listen. I turn the volume down a bit while still allowing the tune to fill the space around me—excellent for focus as I’m working. Not distracting or sleep-inducing, just an effective noise blocker that helps with concentration.

Give this a view – I hope you enjoy it!

Remembering to Do Nothing

(Title image: Photo by Ken Cheung on Unsplash)

I remembered something last night about mindfulness meditation that I’d realized I had somehow forgotten.

I don’t have to do anything when I meditate.

Not strain, nor grip, nor furrow my brow.

The only thing I need to do when I meditate is to exist, and to be aware that I am existing.

I was thankful that I remembered this because I’d been struggling with the concept of sitting and being present for the past few months. I had slipped into the belief that I needed to work at it.

But last night I asked myself, “What would it feel like if I didn’t try so hard? Or at all?”

Simply exist.
(Photo by Jeppe H. Jensen on Unsplash)

If you’ve practiced mindfulness meditation, you know that the guidance is simple and straightforward.

It goes something like this:

“Sit comfortably with a tall spine, alert but relaxed. Take a few deep breaths, stretching upward on the inhale and settling down on the exhale. Soften the muscles of your body starting from your face, moving down the neck, shoulders, torso, arms to the fingers, hips and seat, down the legs to your toes. Then allow your awareness to settle onto a focal point like the breath, tingling in the hands, the hum of an appliance or sounds of traffic in the distance.”

Does that sound familiar? There are of course numerous variations of this. You select an anchor to come back to whenever you realize that you’ve drifted away from the present moment and into the thoughts in your head.

And that’s it. It’s quite basic and yet we find ways to complicate it and make it a strenuous exercise.

You don’t necessarily have to sit, you can lie down or even stand if that works for you (or you’re practicing while queuing up for something).

There are no rules for mindfulness meditation. Yes, there are principles and/or steps to take, but no real way to do it “wrong”. The only thing that would be considered “incorrect meditation” would be going to meditate, but then spending all that time doing something else.

Last night, when I remembered that my meditation didn’t have to be a certain way and all I needed to do was simply to be and to be aware of myself being, it felt like a release. The last year has been difficult and there have been tough things that I have been required to do.

This felt like a gift, that I could rest and think, “Oh, yeah…I don’t have to do anything.” And I was so grateful for that moment.

Why do I make these things so much harder than they should be?

Bang a Gong: The Problem with the End-Of-Cancer Treatment Bell

(Title image: Photo by rhoda alex on Unsplash)

When I finished my final radiation treatment for breast cancer in 2017, I got to bang a gong as part of my cancer center’s tradition.

The gong-ringing marked getting to a milestone, one that I only dreamed about when I was handed my treatment plan. It felt like closure…except that I wasn’t really “done”—I still had months of Herceptin to go and years of endocrine therapy ahead of me. But the toughest chemo and radiation were over.

And those around me who weren’t done yet also celebrated along, just as I had for the patients that had gone before me, eagerly awaiting their turn at the gong. This tradition also occurs at many other cancer centers, although instead of a gong, it might be a bell or a chime or something similar.

However, as with many things that have to do with cancer, there is a more somber side to the end-of-chemo bell. As noted in this article from Psychology Today (“The Psychology of the Cancer Bell”), hearing the ringing of the bell can be devastating for someone with metastatic cancer, who will never be done with treatment, or is at late stages of the disease.

There are many other creative ways to commemorate the end of treatment for cancer than simply bell-ringing.
(Photo by Nick Fewings on Unsplash)

The article also points out that in cases where someone experienced a cancer recurrence, hearing the bell rung by someone else elicited painful emotions. What should be a jubilant event for all can feel depressing and isolating, like being left behind.

But it goes beyond that. As a study by Williams et al. (2019, Int J Radiat Oncol) found, even those who are finishing their treatment might not have a positive response to ringing the bell. From the “Conclusion” section in the study’s abstract:

“Counter to our hypothesis, ringing the bell on the final day of RT [radiation therapy] worsens patients’ evaluation of overall distress from cancer treatment, and this distress persists and even worsens in the months after treatment. Emotional arousal created by ringing the bell may magnify the distress from cancer treatment and subsequently worsen the perception of distress from treatment.“

Not what I would have expected! And it certainly came as a surprise to the study’s authors.

These findings have been reflected in a reimagining of the completion bell. As the Psychology Today article mentions, some cancer centers are moving it’s location and renaming it the “Bell of Hope”, or providing different means of allowing patients to mark the stages of their treatment rather than focusing on “completion”.

Personally, I was looking forward to banging my gong and was more focused on what treats I could bring for the radiology staff and saying goodbye to all of them. But I can see why such a commemoration could be problematic, especially when so many parts of the cancer experience are stressful. You don’t need one more.

How about you? How do you feel about ringing a bell (or similar)? Is there something else that you did or would prefer?

REFERENCES

Leeby C, July 30, 2025, The Psychology of the Cancer Bell. Psychology Today Blog, https://www.psychologytoday.com/us/blog/consciously-creating-your-soul-life/202507/the-psychology-of-the-cancer-bell

Williams PA et al. (2019) The Cancer Bell: Too Much of a Good Thing? Int J Radiat Oncol, 105, 247-253. https://www.redjournal.org/article/S0360-3016(19)30838-7/abstract

For information on what Penn Medicine has done to reimagine the bell-ringing tradition:
Greer M, December 23, 2022, Redefining the Bell Makes the Ritual Inclusive for All Patients With Cancer. ONS Voice, https://www.ons.org/publications-research/voice/news-views/12-2022/redefining-bell-makes-ritual-inclusive-all-patients