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Cancer survivors may face challenges during adoption process
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Cancer survivors face increased challenges when they try to adopt a child, according to study results.
The findings suggest survivors could benefit if care providers offered information to help with decisions about adoption and fertility, researchers wrote.
Many young cancer survivors become infertile after therapy, prompting some to consider adoption. However, little data exists on successful adoption rates for cancer survivors, according to study background.
Gwendolyn Quinn, PhD, senior member of Moffitt Cancer Center’s health outcomes and behavior program, director of the Moffitt survey methods core and professor at University of South Florida College of Medicine, and colleagues asked oncology nurses participating in a training program to conduct interviews on this topic with adoption agencies.
Gwendolyn Quinn
“[The nurses] were surprised to learn that cancer survivors may face additional challenges when adopting a child,” Quinn told HemOnc Today. “The need for documentation from their oncologist that they are cancer free can be a challenge. This requirement may also violate the Americans with Disabilities Act (ADA).
“However, they also learned that some women placing a child for adoption may intentionally seek a cancer survivor, believing survivors have a greater appreciation of life,” Quinn said. “The learning activity prepared oncology nurses to provide better education and information for decision-making for young adults as they explore reproductive health options.”
The analysis included 77 nurses from 15 states who identified a local, state or international adoption agency and conducted an interview using a semi-structured guide. After these interviews, nurses summarized the adoption agencies’ responses, and researchers used a qualitative content analysis to examine the results.
The investigators assessed several factors, including adoption costs, steps required for cancer survivors seeking an adoption, challenges for those survivors, and reservations or concerns of birth parents.
The majority of the nurses expressed surprise at the high cost of adoption fees. Results indicated adoption fees ranged from $3,000 to $75,000, with most between $20,000 and $30,000. Lower fees usually were reserved for special needs or older children.
Not all agencies kept track of whether prospective adoptive parents were cancer survivors, but those that did reported an average of 10 survivors seeking adoption annually.
Cancer survivors often needed to complete additional steps in the adoption process. They included obtaining a letter from a physician explaining the health of each potential parent. Most agencies required that health records be shared with the birth mother. Some agencies were more restrictive for cancer survivors, requiring a 5-year cancer-free period before being able to adopt.
Some adoption agencies reported that life expectancy was an important factor when determining the suitability of a cancer survivor to be an adoptive parent, whereas others required a mental health and support process for cancer survivors.
Although not unique to cancer survivors, some of these categories (eg, cost, wait time and a disclosure of one’s medical history) could pose significant barriers, according to researchers.
More than 50% of the agencies reported that cancer history may have a positive impact, in that birth mothers may feel confident choosing a parent who has overcome hardships and appreciates life. However a few agencies indicated a cancer history could be discouraging for a birth mother.
About 50% of the nurses involved in the study said they now would discuss adoption and fertility preservation with their patients. However, about one-third of the nurses indicated adoption should be mentioned only briefly, as they preferred to discuss egg, embryo or sperm fertilization as primary options. A small percentage of nurses suggested adoption should only be discussed if other fertility preservation options failed or were not desirable.
Most nurses who participated in the study indicated there should be improvements in education and resources so they can better inform cancer survivors about adoption as a family-building option.
“This education would also allow nurses to be better equipped to provide insight for patients with cancer who presume adoption is a failsafe method for having a family, or for survivors who seek adoption and are uniformed about the process,” Quinn and colleagues wrote. “Nurses serve as educators, advocates, reporters and information gatherers who continually evolve with the need of the patients. Understanding the challenges and facilitators of adoption for cancer survivors will allow oncology nurses to be confident when discussions arise.” – by Anthony SanFilippo
For more information:
Gwendolyn Quinn, PhD, can be reached at Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612; email: gwen.quinn@moffitt.org.
Disclosure: The researchers report no relevant financial disclosures.
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