ST. LOUIS • Alex Onkle, 6, has the worst kind of tumor — rare and aggressive. He undergoes five days of chemotherapy every two weeks at Cardinal Glennon Children's Medical Center. In between, he is at the hospital twice a week for blood tests and transfusions.

Every morning as he arrives, and every afternoon as he leaves, the boy with thinning brown hair and glasses stops at the treasure chest at the foot of a giant Christmas tree in the hospital lobby. The brightly colored chest holds hundreds of notes, rolled into tiny scrolls.

Alex walks up the purple carpet leading to the chest and pulls one out. His mother, Wendy Hall, 38, of south St. Louis County, knows the drill.

She unrolls it and reads: "Dear frend, I'm thinking of you. Your family is probly sad, so I hope you can get up out of the hospital and go run around with your frends! I hope you feel better soon. Merry Christmas. Cincerely, Henry."

So far, more than 5,000 people have sent encouraging notes for patients. Volunteers check them, roll them into scrolls and place them in the chest. Giant signs encourage children and caregivers: "Please take a free Message of Hope, and know people in the community are cheering for you!"

The note-writing project was the idea of Dan Buck, director of the Cardinal Glennon Children's Foundation, the fundraising arm of the hospital. People often tell him, he said, that they want to do more for the patients.

"When I ask them what they want to do, they say, 'We just want those kids to know we care about them,' " he said.

Other children have written most of the messages, which also serve as an exercise in giving. "This makes them realize that there are kids that have more pressing issues than what is going to be under the tree this year," Buck said. "This is a great opportunity for them to be grateful."

The notes have been extremely popular. Nurses grab a dozen to deliver to their patients at the beginning of their shifts. Siblings pick them up to read to their brother or sister.

Because Alex loves the messages so much, his mom said she keeps each one in his scrapbook. He especially enjoys the longer notes, she said, and ones that say keep your head up, stay strong. "He has a sense of pride for those notes," she said.

Alex also creates messages for other patients, sliding them into a drop box next to the chest. He can't write, but he'll draw a happy face or use Christmas stamps and sign his name. "He enjoys them so much, he wants someone else to enjoy one, too," his mom said.

The notes are uplifting for her as well. Alex was diagnosed with desmoplastic small round cell tumor two months before his fifth birthday. He's undergone surgeries, radiation and chemotherapy to remove tumors spreading through his body. Plans are in the works to get Alex into Sloan-Kettering Cancer Center in New York, where scientists are studying new antibodies that can direct immune system cells to attack the tumors.

"To know that people actually care," Hall said. "Words go a long way. They really do."