HONOLULU (HawaiiNewsNow) - On a hospital bed at Kaiser Moanalua, five-year-old Xander Engelman sits between his parents and adds to his collection of colorful beads.
"There's a yellow one for any time we have to stay in the hospital. The white beads mean chemotherapy. There's a tortoise colored bead that means any lumbar punctures," said his mother, Alicia Bolosan.
They are called Beads of Courage and they are rewards for kids undergoing treatment for cancer.
Kaiser is one of 70 hospitals in the program that was started in Arizona in 2004.
A nurse wanted children and young teens with cancer to have something they could hold to acknowledge their bravery.
Geila Fukumitsu heads up Kaiser's Child Life Services wing.
One of the best parts of her job is handing out the beads.
"For most of our pediatric patients it's really a milestone. It documents their journey through the whole cancer treatment," Geila Fukumitsu said.
Xander's journey started when he was just 23 months old after he kept getting sick.
"They did a bone marrow aspiration," Bolosan said. "They found leukemia blasts in his bone marrow."
Doctor Martin Piette has taken care of Xander from the time he got his first beads three years ago.
"We give stickers to kids who get shots. This is beyond that," he said. "When kids come in for chemotherapy, oftentimes they'll show their beads. It also opens up sort of a opportunity for communication for both the patients and the families."
Xander's sister, Zoe, also has beads for every procedure her brother's been through.
There have been a lot of them.
Xander's strand is fifteen feet long. By some standards it's short.
"We had a patient. We actually measured it out to be almost the length of a football field," Fukumitsu said.
On Tuesday, Xander's string of beads reached the end of the line with a bead in the shape and color of a purple heart.
"It signifies the end of treatment so that's kinda cool," Bolosan said.
Xander's condition has improved enough that his parents plan an I Beat Cancer party for him next month.
His beads tell his story without saying a word.