Anita Cox of Snoqualmie retired in June 2011 after teaching for 36 years. The last school she taught at was Christa McAuliffe Elementary in Sammamish, where she worked for 16 years.

Unfortunately, the joy of her retirement was thrown off balance. One month later she was diagnosed with stage IIIc uterine cancer. Cox finished her treatment in March this year.

Cox, 63, had all of her treatment — chemotherapy and radiation — at Swedish Issaquah. She wanted a symbol for patients who were completing their treatment to mark the occasion. How about ringing a bell to celebrate the last treatment?

“A very dear friend who was diagnosed with breast cancer had heard about the idea and donated a bell to the hospital in Georgia where she had received her treatment,” Cox said. “Sadly, my friend has recently seen a recurrence of her cancer. That makes the donation of the bells even more significant to me.”

The bell-ringing tradition is now widespread. It was introduced in 1996 at MD Anderson Cancer Center when U.S. Navy Rear Admiral Irve Le Moyne, a patient with head and neck cancer, installed a brass bell at the main campus radiation treatment center in Houston and in Albuquerque, N.M.

Cox said she went online and saw that several hospitals throughout the country had bells used for cancer patients to ring as a symbol of completing a step in their treatment plan. With permission from Swedish, she found the bells and plaques that she wanted to donate to both the infusion center and the radiology unit.

It’s a small but meaningful way to celebrate when you exit treatment for the last time.

“Then I found several possible quotations to put on the plaques,” she said.

Cox wanted to see which quotations people felt were most appropriate. Interestingly, there was no clear consensus.

“I guess that just validates the idea that everyone’s cancer journey is different,” Cox said.

In the end, Cox selected the quotations that spoke to her and her own journey. For the plaque outside the infusion center she chose “Some days there won’t be a song in your heart. Sing anyway,” by Emory Austin.

For the radiation unit she chose “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face,” by Eleanor Roosevelt.

Amy Christian, manager of Swedish Cancer Institute Issaquah, and Eastside Oncology, said Swedish had to be sensitive about the bells because although some patients will want to celebrate and ring the bell, others might have mixed emotions because they know they’ll never recover. But, Christian said, the bells have been received positively.

“People have the option,” Christian said. “If you would like to, you can do this as celebrating this milestone in your life.”

Cox said the wife of another patient also brought a bell for her to ring on that special day. Her radiology technicians even played “Makes Me Want to Shout,” her request, as she endured her last radiation treatment.

“When I got off the table, we rang the bells like crazy and the techs presented me with a ‘radiation graduation’ certificate,” Cox said. “I felt such enormous relief at having made it to the end of my cancer treatment. I wanted to be able to give that same sense of accomplishment and joy to others dealing with cancer.”