Ringing a Bell on the Final Day of Radiation Therapy in Improving the Memory of Distress in Cancer Patients

PRIMARY OBJECTIVES:

I. To determine if the simple act of ringing a bell at the end of radiotherapy can improve
the retrospective evaluation of distress due to radiotherapy and other prior cancer therapy.

SECONDARY OBJECTIVES:

I. To measure the severity of patients' memory of distress from cancer treatment.

II. To assess the relationship between anxiety to actual distress and to remembered distress.

III. To assess the relationship between optimism-pessimism personality to actual distress and
to remembered distress.

IV. To assess patient's cognitive dissonance reduction to actual distress and to remembered
distress.

OUTLINE: Patients are assigned to 1 of 2 groups.

GROUP A (No bell ringing): Patients undergo standard of care radiation therapy with or
without chemotherapy.

GROUP B (Bell ringing): On the final day of standard of care radiation therapy, patients ring
a bell in the clinic.

After completion of study, patients are followed up for 7 months.

Inclusion Criteria:

- Diagnosis of cancer

- Definitive radiation treatment with or without concurrent chemotherapy with curative
intent; treatment prior to radiation therapy is acceptable (e.g. surgery,
chemotherapy)

- Ability to understand and the willingness to sign a written informed consent; consents
will be provided in English or Spanish

- Able to speak English or Spanish (questionnaires will be in English and Spanish)

Exclusion Criteria:

- Patients with either a malignant central nervous system (CNS)-primary cancer or with
brain metastases; patients do not need to undergo brain imaging unless indicated per
standard workup and management (e.g. advanced stage lung cancer receiving definitive
therapy)

- Patients who will be receiving surgery or adjuvant chemotherapy within 1 month
following radiation treatment

- Patients with widespread metastatic disease (> 3 distant metastases); patients with
oligometastatic disease (=< 3 distant metastases) are allowed only if they are
receiving definitive (curative) radiation therapy (RT) with or without chemotherapy