Background:

Childhood cancer survival has improved globally; however, in low- and middle-income countries, gender-based inequities continue to shape access to care, treatment adherence, and survivorship outcomes. In India, girl children with cancer face compounded vulnerabilities arising from social bias, stigma, and limited psychosocial support. This survivor-led study examines the lived experiences of girl childhood cancer patients and survivors, with a focus on bias, stigma, and pathways to empowerment.

Methods:

A cross-sectional study was conducted among 82 female childhood cancer survivors registered with CanKids…KidsCan across six Indian cities. A structured questionnaire using a five-point Likert scale assessed challenges prior to treatment, worries during treatment, post-treatment survivorship concerns, experiences of stigma, and factors contributing to empowerment. Quantitative data were analysed using descriptive statistics to identify major and moderate concerns, while survivor perspectives informed interpretation.

Results:

Major pre-treatment challenges included disruption in education, financial constraints, travel difficulties, delayed diagnosis, and coping with initial symptoms. During treatment, painful procedures and fear of treatment-related side effects emerged as primary concerns. Contrary to prevailing assumptions, fear of death and social reintegration were reported as minor worries, attributed to sustained psychosocial and peer support. Survivors demonstrated high levels of empowerment, expressing confidence in disclosure, forming new social connections, and supporting newly diagnosed girls. Survivor-led peer support models, including girl brigades and survivor forums, were identified as critical in reducing stigma and strengthening treatment adherence.

Conclusion:

The study highlights the transformative role of survivor-led, peer-supported interventions in addressing gender bias and stigma in childhood cancer care. Integrating survivor voices into primary care and public health strategies can strengthen psychosocial support, promote equity, and improve long-term survivorship outcomes. This model offers valuable lessons for gender-responsive cancer care in resource-constrained settings.

Ritu Bhalla is a two-time blood cancer survivor and a survivor leader from New Delhi, India. She is a passionate patient advocate working to challenge stigma and amplify survivor voices in policy, research, and care delivery. Ritu is a Governance Council Member of the Indian Childhood Cancer Initiative (ICCI) and a survivor leader with CanKids…KidsCan. She has contributed to survivor-led research on gender bias, stigma, and quality of life and has represented survivor perspectives at WHO SEARO and ICMR platforms. A postgraduate from the Vedica Scholars Programme for Women, she now serves as Senior Manager, Programme Development at Vedica. Ritu also co-leads KidsCan Konnect, a teenage and young adult survivor group at CanKids, and champions girl child cancer advocacy. Married to fellow survivor Chandan Kumar, they break societal stereotypes as a “survivor power couple” and are parents to a little girl. Ritu also holds leadership roles as a Member of the Survivor Network Development Working Group for CCI Asia.