The first time these three little girls met, each was battling cancer.
They turned up to a photo shoot in the studio of Lora Scantling in 2014. In a social media post, the Oklahoma photographer had asked if anyone knew little girls who were bald from cancer.
Prompted by the loss of family members to the dreaded disease, Scantling had a vision of a statement she wanted to make about cancer. The subjects would be children. They would be dressed in pearls and lacy dresses. They would put a child's innocent face on a disease that affects every age group.
"None of us knew how big of an impact it would be," Scantling told InsideEdition.com Wednesday. "Within a day or two, it went viral." The photo shoot images popped up all over world. People began writing to the photographer, asking for updates on the children.
So the girls gathered every year for an updated portfolio. Five years later, they all are cancer-free.
"If you watch a sick kid, it pulls your heartstrings," Scantling said. "It was like, 'Oh my God, these poor little kids.'''
Her point, Scantling said, was to spotlight cancer and the need to fight it in every imaginable way.
Last year, she added Connor Lloyd to the group. The little boy is being treated for acute lymphoblastic leukemia and his family had been photo clients of Scantling before he got sick.
She said that when people view her photos, "It's terrifying and it's beautiful."
For this year's image, Scantling posed the four kids with photographs of Scantling's "fallen fighters" — nine children who died while fighting cancer.
It is important, she said, to honor the dead as well as the survivors.
"Those parents were beyond honored and thrilled for their little ones to be remembered," she said.
And positive reactions keep pouring in, she said.
"It always surprises me," she said. "For people to care this much, we just didn't expect it."