Adoption poses challenges for cancer survivors

Cancer survivors' options for adoption may be limited by adoption agencies' policies. A study published in Cancer (2015; doi:10.1002/cncr.29322) indicates that a training program for oncology health care providers can help them provide valuable information to patients who are making decisions about fertility and adoption.

Because cancer and the therapies used to treat it can leave some patients infertile, many young cancer survivors turn to adoption when hoping to start or add to their family. Adoption can be a long and costly process, though, and cancer survivors may face additional challenges that may even be perceived as discriminatory.

Because little is known about the rate at which cancer survivors successfully adopt a child or about their experiences during the adoption process, a team led by Gwendolyn Quinn, PhD, and Susan Vadaparampil, PhD, of the Moffitt Cancer Center in Tampa, Florida, asked oncology nurses who were participating in a training program to contact and conduct interviews with adoption agencies. Seventy-seven nurses across 15 states provided summaries of their interviews.

The nurses reported a range of adoption fees from a minimum of $3,000 to a high of $75,000. Not all adoption agencies kept records on whether prospective adoptive parents were cancer survivors, but those that did track this reported an average of 10 former patients with cancer a year seeking adoption. A few agencies reported that a cancer history in an adoptive parent could be discouraging for a birth mother, but most reported the opposite, which was that birth mothers might feel confident in choosing a parent who has overcome hardships and has an appreciation for life.

Agencies usually required adopting parents to provide a letter from a physician regarding their health and medical history. Quinn noted that this exposes a potentially discriminatory practice akin to restricting employment opportunities for people with disabilities according to the Americans with Disabilities Act (ADA). The nurses also found that international adoptions had greater restrictions for prospective adoptive parents with a cancer history.

After conducting the interviews, the nurses in the study reported feeling that they had gained valuable information about the adoption process, and they felt an improved ability to discuss adoption with patients undergoing cancer treatment.

“This study showed that nurse learners in a training program became more knowledgeable about the difficulties with adoption in cancer survivors, and it is hoped that they will be able to better inform their patients about parenthood options for the future, based on what they learned in this activity,” said Quinn. “Additionally, perhaps this data will bring to light the need for policy revisions in adoption processes that comply with ADA requirements.

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