Adoption after cancer

In this guest blog post, Emma Owen from PACT discusses adoption after cancer and finds out the answers to some of the Shine Cancer Support community’s burning questions.


As a charity that finds adoptive parents for children in care, we get all sorts of questions from people who want to find out more about whether adoption is right for them. We get asked frequently:  “Do I have to be married or in a relationship, or can I adopt on my own?”, “Do I need to own by own home?” or “Can I adopt if I’m gay?”. 

The answers to these question are straightforward – Yes you can adopt on your own, no you don’t have to own your own home, and yes, you can adopt if you are gay!

But when it comes to health there is no one answer for all. Every single case is individual and different to the next person. We frequently get asked whether someone who has had cancer can adopt. The short answer is – possibly.

The first thing to remember is that having had a cancer diagnosis and treatment does not automatically prevent anyone from being accepted, assessed and approved as an adoptive parent.

In fact, tenacity, resilience and positivity that people have demonstrated while undergoing treatment for cancer are great qualities for adopters. But this needs to be balanced with ensuring that an adopter has the energy and strength to parent their child into adulthood and beyond.

As well as thinking of your own hopes and dreams for a family, you must also think of the needs of the child. An adopted child will already have suffered loss, and possibly trauma, and any adoptive parent must be emotionally, as well as medically, fit to care for a child who has had a difficult start in life.

As part of the adoption process you will need to have an adoption health assessment with your GP and this will need to be seen by PACT’s medical adviser. Your treating consultant will be asked for a reference and their view will be influential in the decision as to whether you can proceed with adoption.

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PACT’s medical advisor Dr Efun Johnson said: “The assessment process seeks to explore individual strengths to parent, using available health information on health status and likely risks that may impact on meeting the physical, emotional and developmental needs of a child.” 

I asked Dr Efun to answer some of the most common adoption questions we get asked by people who have suffered from cancer.

Q: Do you have to wait a certain length of time after you finish treatment before adoption agencies will accept you? 

Dr Efun: “Every cancer differs and detection could be at differing stages. After treatment and remission or cure we would ask that you give yourself a year or two to settle before you apply to adopt. In some cases you may need to wait up to five years. 

Q: What if you have disabilities after cancer treatment and your partner had cancer too or has health issues – is adoption still an option?

Dr Efun: “It is the capacity and ability to look after and parent a child that is looked at as well as both yours and your partner’s health. Yes adoption is still an option. 

Q: What if you have cancer long term but it’s not currently life-threatening, can you adopt then?

Dr Efun: “It depends on the individual situation.”  

We also have some more general questions, which I put to PACT’s Adoption Team Manager Mandy Davies.

Q: If cancer leaves you unable to adopt, would it be possible for your partner to adopt a child in their name only? Then share parenting commitments? 

Mandy: “While a couple are living together there would need to be a joint assessment.  If we were not able to proceed due to cancer it is likely to be because of a limited life expectancy.  If an adoptive parent were to die, this loss would have a huge impact on an adopted child who will have already lost their birth parents and probably foster carers.”  

Q: What are the first steps if I want to find out about adopting?

Mandy: “Do your research into what’s involved in the process, the children waiting and all the things any adoptive parent needs to consider. We have a Guide to Adoption on the PACT website which is a great place to start. Then I’d suggest coming along to an information event. At PACT information events we have talk from a social worker about the process and an adopter to tell their story and you have the opportunity to ask any questions.”

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At PACT, we have many survivors of cancer who have successfully been approved as adopters and gone on to have a family through adoption.

Marcia and her husband adopted their two daughters after she was diagnosed with breast cancer, and successfully treated with an aggressive course of chemotherapy and a mastectomy. 

She said: “We were devastated, but the prognosis was positive. The oncology and fertility consultants worked with us to ensure I could have some eggs removed, and we had our embryos frozen. Post chemotherapy, we had to wait two years until we could have the embryos implanted. We had two unsuccessful attempts of IVF. 

For the next six months we took a long needed holiday and took the opportunity to consider our future as a family and we agreed to continue to explore the option of adoption.”

Marcia and her husband were approved through PACT and became parents to two sisters, aged one and two at the time. 

“We were really lucky, the girls took to us and their new home immediately. All the preparation work and transition went really well and they could just get on with being children.”

Marcia is a wonderful example of someone who has created her family through adoption after cancer. And in a society where there are three times as many children waiting than there are approved parents we do need more people to consider adoption. So don’t let cancer be the reason you don’t think about it. Every single application to adopt will need to be considered on an individual basis so do get in touch if you’d like to know more.

About PACT

Parents And Children Together (PACT) is an independent adoption charity and family support provider which last year placed 93 children with 64 PACT families through its adoption services. It is rated outstanding by Ofsted and provides award-winning adoption support to its families for life.

PACT is one of 34 voluntary adoption agencies in the UK which find, assess, approve and support adoptive parents. VAAs work in partnership with local authorities to find homes for children in care who are unable to stay with their birth families. To find out more about adoption visit www.pactcharity.org or to find a VAA local to you visit www.cvaa.org.uk

Emma Owen

Emma Owen

Emma Owen is PACT’s Head of Marketing and Communications.

Life – but not as you knew it: Coping with infertility

In many cases, cancer treatment affects fertility.  Here at Shine we know that (a) health care practitioners don’t always deal with fertility and cancer issues very well and (b) questions about fertility can be one of the toughest things to deal with after a diagnosis.  Shine’s 2012 survey of young adults with cancer found that a whopping 50% of people didn’t feel that they’d been adequately supported to preserve their fertility prior to starting treatment.

In our latest blog, Rhian Jenkins (who also coordinates Shine’s Cardiff network) shares her story of diagnosis with ovarian cancer at 25, and how questions about her fertility have impacted upon her.

If you’d like to chat to others about your experiences, why not request to join Shine’s private Facebook group? We’ve got 400 men and women chatting cancer there – we’d love to see you.


Rhian Jenkins

Last week I discovered that I have gained five unwanted, un-shiftable pounds. As I stood in the tiny room at my GP’s surgery, my toes gripping the scales, I hastily added two inches when the nurse asked ‘height?’ in the hope of achieving a more desirable BMI.

The bad news: The nurse didn’t believe me and instantly had me standing flat-footed against her height chart while I mumbled something about wearing platforms last time I was measured.

The good news: Not even the most furrowed-browed of nurses tells the only twentysomething in menopause clinic to eat less cake.

I was 25 when I was diagnosed with germ cell ovarian cancer. At first, I was thought to have a cyst and, reassured by everyone’s affirmations over my general health and my age, I set off for an ultrasound expecting to hear what statistics would have me believe. The walls in the waiting room were plastered with posters on nursing and the chairs were filled with expectant mothers. As I fleetingly fretted over losing my fertility to a benign condition, I was ill prepared to be plunged into a world of tumours and treatment decisions.

The nature of my cancer and treatment left little chance or time for debate regarding fertility preservation. I began chemotherapy a week after diagnosis in the vain hope that my remaining ovary would jump back to attention once treatment ended. The almost poetic irony that the very ‘things’ that were meant to be a source of new life were on a mission to kill me was not lost on me – I tried desperately to see the funny side.

At the beginning of treatment, when your mind is preoccupied, it can be difficult to discern the importance of losing your fertility. At that point, it’s just another potential ingredient in a monstrous, scary, side-effect sandwich. Every time I tried to brush aside conversations about the possibility of infertility and claim I wasn’t that bothered, my consultant reminded me that ‘our aim is that one day it WILL matter to you.’ It seemed like something that was so far away, so hypothetical, and so disconnected from anything I was going through that it seemed an absurd thing to worry about. It was only when the twelve month post-chemo bell rang and I gained the official title of ‘menopausal’ that I began to realise and, dare I say, resent how different my life looked because of cancer. I sat once again in the same old waiting room, this time to collect my prescription for hormone replacement therapy (HRT).

Throughout treatment I vowed that if I couldn’t always be positive, keep my chin up, or stay true to any of the other clichés often demanded of cancer patients that I would, at the very least, remain compassionate towards others. I didn’t want my own cancer-filled universe to consume me. I didn’t want to become bitter or maudlin and I tried hard to avoid asking ‘why me?’ I placed a great deal of importance on not feeling sorry for myself and got on with what had to be done. Why then, a year after the hardest part of it all, was I feeling so cheated? I felt like a fraud every time I clicked ‘like’ on the scan pictures of acquaintances that appeared on my Facebook newsfeed.

Speaking about fertility is difficult and I guess it’s hard to grasp what it’s like unless you have been through the rigmarole of cancer treatment and losing your fertility. When I try to engage with friends who haven’t experienced cancer they usually look perplexed and cut any potential conversation short with an exclamation of ‘but that’s the least of our worries, right!’. Being fortunate enough to have the luxury of an infertility ‘issue’ combined with the fact that you shouldn’t be menopausal in you twenties is confusing. The turmoil and guilt I feel every time I acknowledge that maybe I’m not OK with the hand I’ve dealt can be hard to deal with.

It’s now two years on from my diagnosis and, like my scars, the issue of fertility is something that serves as a constant reminder of my disease. When I catch myself daydreaming about a future it is usually the future that I thought I would have. In my pre-cancer naiveté I never expected fertility to be a hurdle I would have to overcome. It was certainly never something I thought I would have to ‘work at.’ Instead, I am learning to be comfortable with the uncertainty the future I have been afforded while also learning to be excited, instead of daunted, by the possibilities of adoption, surrogacy or even egg donation/IVF.

Rhian lives in Cardiff and coordinates our Cardiff network.  She’s currently getting ready to go on Shine’s 2015 Great Escape!

Life – but not as you knew it: Pregnant Pause

In our last blog, Sam Reynolds shared her experiences of living with cancer and a small child. But what if your cancer treatment has affected your pregnancy and fertility?

Chemotherapy, radiotherapy and other drugs can all affect the ability to have children. For many young adults with cancer, coping with post-treatment fertility problems can feel like yet another massive hurdle that has to be overcome– and it’s something that has to be dealt with for years after the initial diagnosis. We also know that fertility issues are often dealt with poorly by clinicians; in Shine’s 2012 survey of young adults with cancer, almost 50% of people told us that they hadn’t felt adequately supported to preserve their fertility prior to starting treatment.

Writing poignantly below, our writer tells us about her experiences of terminating a pregnancy, cancer and fertility treatment. Cancer and pregnancy is rare, and we know that there aren’t any easy answers to infertility. We firmly believe, however, that shedding more light on these experience is important. So many young adults with cancer deal with infertility quietly and on their own, struggling to make sense of what they’re experiencing. We want to change that.

To get in touch, please check out our Facebook page, website or follow us on Twitter.

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Pregnant Pause: Cancer, Termination and IVF

Three and half years ago I was diagnosed with bowel cancer, aged 30. I was also eight weeks pregnant with my first baby. The shock of the diagnosis was quickly superseded by having to make some important decisions and take many actions. Requesting to see the top specialists in the areas that I was now acutely involved in – oncology, surgery and gynaecology – it quickly became clear that it would not be possible to keep the baby if I was going to survive. The location of the tumour, and the radical surgery required to remove it, meant that we couldn’t. Having explored as many options as possible, I had a termination two weeks after the diagnosis. I remember asking my husband to write down very clear bullet points about why this had to happen; I wanted to be able to reassure myself later if doubted my decision. We were devastated.

At this point my medical team said there was a chance my fertility would be ok, as long as surgeries and treatment went smoothly. I knew that I may be eligible for in vitro fertilisation (IVF) and I was given a three-week window in which to try it before my first surgery. Despite being told there as a high chance it may not work due to my recent pregnancy and short time frame, we got four embryos for storage.

The next year was spent in a whirlwind of treatments and surgeries, dealing with the very physical and even more emotional changes required to ‘get through’ cancer. All the while I spoke as openly and honestly as I could with family, friends and new people in my life about the experience – how I, we, were feeling, and how I was looking forward to it being over.

Coping with life throughout it all was hard at times, and I felt more fragile and weaker than my ordinary self. I found other people’s good news hard to hear but desperately wanted to be ok with things. Pregnancy news in others was often the worst, although pregnant people or their new babies much less so. I asked people to email me their pregnancy news so I didn’t have to process it face-to-face, but felt guilty about having to do so. I knew I had to be rational about normal life carrying on around me but this still felt so hard. People often said ‘you’re strong, I couldn’t cope with what you’ve been through’ but if I ever wanted to ask ‘why me?’ I tried to remind myself equally ask ‘why not me?’. It’s just a shame it’s anyone.

I had to find a way to accept what was going on and what we had had to do. I remember a friend emailing, saying ‘I’m so sorry about the miscarriage’ and I don’t think I corrected her. I didn’t have the energy to explain it or risk feeling exposed, potentially judged, and even more sad.

Eventually after a third surgery I was told I was cancer-free. It is often at this point cancer survivors talk of their difficulty in adjusting to life – finding their new “normal”, one you didn’t choose or want to have to explore. Despite doing well in many ways – I am healthy again, eating well, and have made exciting changes in my career, the emotional fall out has been had the biggest impact. I feel guilty for wondering whether, had I just had cancer to deal with and not the loss of a baby, would I have bounced back better now? Be more adjusted? I just have to keep being honest with those closest to me about how we’re coping and looking for support along the way.

Being pregnant with cancer is rare but it is not unheard of – 30,000 people aged 25-49 are diagnosed with cancer every year in the UK, about 60% (18,000) will be women and a handful may be pregnant at the time of diagnosis. Another way of looking at it is cancer occurs in approximately 1 in every 1000 (0.001%)[1] pregnancies. I am aware of other people like me now – some have been able to keep their pregnancies, others not. The hardest part is knowing that you couldn’t have done anything differently. I tell myself not to dwell on what might have been but that’s hard when you’re looking at your future, thinking about how things might have been so different.

We have now been trying for a baby for over a year, and I’ve been told that I have physical issues that may make it hard to have a baby. Having just found out our first round of IVF hasn’t worked, my resilience is being truly tested and running low. Despite this, I actually feel clearer than ever about our plan for a family, and I know that we will have a family of our own one day – hopefully sooner rather than later. I hope my future involves acceptance, peacefulness and a happy heart. Isn’t that just what everyone wants?

 

[1] http://www.cancer.net/coping-and-emotions/sexual-and-reproductive-health/cancer-during-pregnancy