Survivors Need More Information About Adoption, and Nurses Especially Well-Positioned to Provide It

Gwendolyn Quinn, PhD

Gwendolyn Quinn, PhD

Younger cancer survivors who hope to start or add to their families need more and better information from their healthcare providers about adoption, according to results of a new study, and oncology nursing professionals are especially well-positioned to provide this support.

The research, published online in the journal Cancer, involved 77 nurses who surveyed adoption agencies across 15 states. Its findings highlight the importance of survivors having a thorough understanding of the costs of adoption, the time it can take, and what role their medical history plays in the process.

With little known about the rate at which cancer survivors successfully adopt a child or about their experiences during the adoption process, a research 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 the center’s ENRICH training program to contact and conduct interviews with adoption agencies.

ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare) is an 8-week eLearning training program aimed at helping oncology nurses get up-to-speed on current research efforts and options to reduce the risk of infertility, as well as provide tools to help them discuss family-building with their adolescent and young adult patients and survivors.

To discuss adoption effectively, healthcare providers need some knowledge of the adoption process as well as varying requirements across agencies, especially as they apply to prospective parents with a cancer history.

Cost is one of the most important challenges survivors who are trying to adopt may face, as many have already been burdened by the high costs of cancer treatment. The survey found a wide range of adoption-related fees—from a minimum of $3000 to a high of $75,000—but most frequently, these fees ranged from between $20,000 and $30,000, and notably, the majority of nurses reported being surprised at how expensive it can be to adopt.

The researchers found that not all adoption agencies kept records on whether prospective adoptive parents were cancer survivors, but those that did track this information, reported an average of 10 former cancer patients a year seeking adoption.

Although a few agencies reported that a cancer history in an adoptive parent could be discouraging for a birth mother, most reported the opposite—that birth mothers might feel confident in choosing a parent who has overcome hardships and has an appreciation for life.

Prospective parents’ medical history is typically required by adoption agencies, and this study confirmed that practice, but worry about it is often intensified among cancer survivors, the researchers noted.

The study found that agencies usually required adopting parents to provide a letter from a physician regarding their health and medical history. Quinn explained in a statement that this exposes a potentially discriminatory practice akin to restricting employment opportunities for people with disabilities according to the Americans with Disabilities Act (ADA), adding that, “perhaps these data will bring to light the need for policy revisions in adoption processes that comply with ADA requirements.”

International adoptions had greater restrictions for prospective adoptive parents with a cancer history, the researchers found. While most countries did not have an outright ban on cancer survivors adopting, most did impose stricter medical documentation requirements for this population, and some restricted cancer survivors’ adoption options to older children or those with special needs.

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

As one nurse in the study noted, “Now, instead of avoiding this topic and deferring to the physician, I can start the discussion and share my information and resources.”

Being well-informed across the board—meaning healthcare professionals and survivors seeking to adopt—is essential: “The most important thing I learned … was to encourage the survivor to do their homework before approaching an agency. Call and ask specific health-related questions upfront, so there are no surprises as the process continues,” another nurse stressed.

Quinn GP, Zebrack BJ, Sehovic I, et al. Adoption and cancer survivors: findings from a learning activity for nurses [published online ahead of print July 13, 2015]. Cancer.