It Becomes an Honor to Know
Kids With Cancer
The efforts of many are an
essential part of treatment
at Kapi‘olani.
 They are
hard-won, these
brightly colored
beads, each
recalling a
memory that
will not be
cast away by
the children who
own them. Blue
beads stand for a
clinic visit, light
green ones mark a
test or scan, silver
and black ones the
poke of a needle, white ones a chemo day,
red ones a transfusion, and the “big hair”
bead is for thinning or loss of hair.
They come in a profusion of colors and
shapes to match a litany of medical interventions,
and are put together on a string.
It is not uncommon for each strand to be
made up of hundreds of beads, sometimes
thousands of them — with every bead
marking a step in the child’s treatment
for cancer.
 They are known as Beads of Courage,
part of a national program that Kapi‘olani
Medical Center for Women & Children
adopted for its young cancer patients on
May Day this past year. One little girl has
tied her strands together into a link that is
now more than 27 feet long.
Beads of courage and affirmation
“Kandis Teho, the mother of one of our
children, knew about the program on the
Mainland and was the catalyst to bringing
Beads of Courage to Kapi‘olani,” says Pam
Carey-Goo, R.N., pediatric clinical coordinator
at Kapi‘olani. “We have about 50
children, and this is something that is
valued by kids of all ages, whether
they are toddlers or teenagers.”
Kapi‘olani, a member of the National
Cancer Institute’s Children’s Oncology
Group, participates in many support
programs for its young cancer patients.
With Beads of Courage, the underlying
idea is that giving children a way to
acknowledge their treatment can potentially
improve the outcome by helping
them become more resilient to their
cancer. Resiliency can decrease distress,
depression and anxiety. It can increase a
child’s ability to cope and stay engaged.
“There are some teens who make artwork
out of their strands,” says Carey-
Goo. “They have put them on wires to
make sculptures. They have glued them
on basketballs. Some kids will take their
Beads of Courage to school for show-andtell.
It’s more than saying, ‘I have cancer.’
It’s saying, ‘I have these 200, or 700, or
thousands of beads. This means I have
had this much chemo, that much radiation,
this many blood tests, this many
transfusions, tube insertions, days in the
hospital or surgeries.’
“The beads are an affirmation of what
they are going through. It shows their
courage. It is also a way of opening up a
conversation, whether it’s with their
friends, nurses or doctors. The result is
that the beads become a tangible symbol
of their strength and courage to overcome
hurdles in their young lives.”
Recognition as a Children’s Oncology
Group member requires Kapi‘olani to
adhere to strict standards of the National
Cancer Institute (NCI). According to the
NCI, providing coordinated treatment as
a comprehensive, multidisciplinary center
improves survival rates by 20 to 40 percent.
“A lot goes into being an NCI member,”
Carey-Goo says. “You have doctors
who are certified in pediatric oncology,
certified pediatric oncology nurses who go
through special classes. We participate in
national clinical trials so our patients
receive the latest care that’s available anywhere
in the U.S. Our patients don’t have
to travel to the Mainland for access to the
most current trials because these resources
are available here.”
 Many hands, pulling together
Beyond clinical excellence, Carey-Goo
says it takes everyone pulling together
outside the hospital, as well as in it, to see
children through what is by any measure
one of life’s most extreme challenges.
Families, volunteers, donors and community
support are indispensable links,
she says.
Carey-Goo points to Beads of Courage
as the most recent example of how families
often know best what kids need, noting
that the hospital loved the idea and was
able to run with it when Larry Taff, and
his wife Dr. Kheng See Ang, stepped up to
the plate with financial assistance. Others
also made donations to ensure that the
program could continue. Philanthropy is
a critical component of our Children’s
Hospital. All the kids here receive the
same top-notch cancer care, regardless of
their ability to pay. Individual donations
help Kapi‘olani maintain our excellence
in cancer care for all of our keiki.
The list of other team support runs
broad and deep. For example, for the past
17 years, the Greek Ladies Philoptochos
Society of Saints Constantine & Helen Greek Orthodox Church have donated
airline coupons to help neighbor island
families travel to Honolulu for cancer
treatment. And families can count on
the Hawaii Children’s Cancer Foundation
for assistance with daily living expenses.
Often, one parent will be out of work to
remain with his or her child during treatment. The Foundation’s support helps
these families make ends meet.
The American Cancer Society sponsors
three camps every year, and Kapi‘olani’s
Art for Life program brings art therapy to
the children in the hospital and to those
visiting for outpatient treatment.
Kids help kids, too. Carey-Goo’s daughter,
a junior at St. Andrew’s Priory, trained to
become a Beads of Courage Ambassador
and now maintains an inventory of
several thousand beads.
The beginning of a journey
“It’s the child’s
choice to decide
whether to start a
bead collection,”
says Carey-Goo,
“and almost all of
them do. When a
child joins, we have
an alphabet box of
beads. They spell out
their name in beads
and put it on their
strands. For every hundred beads, they get
to choose a special one from the Hundred
Beads Club. Individually handcrafted
beads, donated by artisans from across
the country, mark special hurdles.
 JoLyn Valoroso The Beads of Courage program is a
success at Kapi‘olani. It is a significant
and appropriate way to reflect on each
step and milestone in a child’s journey.
And because beads are visual, both
patients and those who love and care
for them have a way to acknowledge
their courage. Kids of any age sense
this intuitively.
What Do
Kids and
Parents Say
About the
Beads?
Hilo 8th grader Jordan Toler
was one of the first Beads of Courage
members. He recently completed his
treatment and says he’ll look back at his
beads to see just how many treatments
he went through. He recommends other
kids participate as a way to always
remember their journeys. As for the
future, Jordan is looking forward to
trying out for football this year!
Five-year-old JoLyn Valoroso (above)
started kindergarten this year and
proudly shares the newest additions to
her bead collection. Her father Joe says
that the Beads of Courage represents
the “roadmap to JoLyn’s recovery.”
He says her necklace is nearly full —
coinciding with the last couple months
of her treatment in a three-year journey
of pokes, checkups, blood-draws and
hospitalizations.
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