August 22, 2013 at 6:18 am 7 comments


Me & Mae (domestic adoption at 4 mo.)

As an adoptive mama with a cancer history, I’m often asked about the adoption journey for cancer survivors. Our friend Nikki who works as an adoption social worker sat down with me many moons ago as I researched my adoption options.

That coffee date has always stuck with me as it provided great insight.

So – it’s with complete joy that I bring you some Q&As with Nikki – one of the best adoption social workers out there. (And she just so happens to be going through her own adoption process right now, too!)

Nikki’s answering some of the most commonly asked questions I hear from cancer survivors who want to adopt.

Enjoy our first post & stay tuned for more to come!



Meet Nikki, licensed social worker

Questions answered by Nikki DeSimone Pauls, MSW – August 2013

Q:  What are the types of adoption I can consider if I’ve had cancer?

A:  The only type of adoption that may be completely closed to certain cancer survivors is embryo adoption, based on what treatments they had and if those treatments rendered the individual infertile. Everything else is a possibility:  domestic adoption (both private and through the state) as well as international adoption.

Q: Are there any adoption paths/options NOT open to me as a cancer survivor?

A:  I don’t see any options that are not available on the whole. Most types of domestic adoption will be options, as will quite a few international options. Foster care, or adoption through the state, would generally yield even more flexible options.

Q:  What does a social worker look for in a couple who’s ready to adopt?

A:  Being a social worker who has written favorable home studies for cancer survivors, the thing I look for most is their oncologist’s report and supplemental medical letter. I also talk with the client for more information.

One recent example:
A prospective adoptive mom found out she had breast cancer the day I sent her the draft of the home study. A few days later she was scheduled for surgery and then had to reply to my request for her to submit changes needed to their home study. Boy, did she have a big change to submit! I did write a favorable home study; however, it was conditional based on the outcome of her surgery and treatment. As soon as the home study was done, the couple effectively went on hold. The surgery went well, treatment even better, and when she had been over one-year cancer free, she got a fantastic note from her oncologist. I did a home study update and they were placed with a baby a couple of months later. I had a lengthy note from the doctor so I was able to make the assessment that her prognosis was excellent, so I basically used that information in the home study and it went just fine.
This is clearly best case scenario, I know they can’t all be this great, but for example-sake, this was a good one.

Q:  Will having cancer impact eligibility to adopt in any way?

A:  A person who is currently undergoing cancer treatment should be 100% focused on their health and treatment and not focusing on adoption. But after cancer, and with a good prognosis, there are very few limitations for a cancer survivor.

Q:  Is there special documentation is needed for a cancer survivor to adopt?


My oncologist Dr. Rosen wrote a great letter for us when we adopted Mae.

A:  Yes, the oncologist’s letter is paramount. Ideally, the letter will include:

  • what type of cancer
  • what stage it was caught
  • treatment plan
  • expected prognosis
  • percentage of recurrence (if that information is able to be stated)
  • if the physician would recommend the patient for adoptive parenting

The social worker will use this in making his/her favorable determination for adoption and may also pull quotations out of it for the home study (as home studies become legal documents.) So, getting a letter as favorable as possible is helpful.

In the above example that I gave about the gal who found out about her breast cancer on the day of the home study finalization, her doctor’s letter was so favorable that due to the early time period of catching it, aggressive surgery and treatment (double mastectomy, hysterectomy, chemo, and radiation), the percentage chance of her cancer recurrence became less than me getting breast cancer in the future. So being able to summarize that in the home study was compelling and the judge had absolutely no problem with it.

Q:  Do I need to be in remission for a certain amount of time before I can pursue adoption? How long?

A:  In talking with others about this, and after taking my own personal opinion into effect, we all believe that at least one year in remission is a good amount of time. In addition to the toll it takes on the survivor’s body, possible hormone imbalances, stress on the marriage and family, financial stress, time off work, etc., may all add up after a cancer diagnosis. One year out seems to be a good amount of time. That’s really the case in anything adoption though!

We social workers like to see a year after a life-changing event regardless of if the event is happy, sad, or scary, so this is no different. Some international countries will have additional requirements, such as needing someone to be 5-years in remission, and some agencies have their own requirements, others of them 3-years in remission, but that is all on a case-by-case basis.

Q:  What are some good resources for cancer survivors to look into when researching adoption adoptions?

A:  I think just talking with social workers and adoption agencies about the possibilities for adoption is a great place to start. We can help with some of the basic information and research anything that is unknown. Things are so conditional when it comes to this topic, nothing is black and white, and talking with someone is a great idea for gathering accurate information specific to your case.

For example, I would be a lot more inclined to approve a family similar to the one I’ve been referencing here throughout, rather than someone who just had the one breast removed, no hysterectomy, and tested positive for the BRCA 1 or 2 genes.

Additionally, no two adoption agencies or social workers are going to react the same way, too. I’m more on the cautious side, but I also place a lot of emphasis on the oncologist’s letter. Whereas, someone who has never worked with a cancer survivor before, and has some negative family history (e.g., mom died two years ago from cancer), might not be as willing to consider the prospect. has a helpful resource page for cancer survivors. I also recommend calling an adoption consulting agency to talk to experts about your particular case. Consulting agencies network with a lot of adoption agencies and are advocates for those wanting to adopt. They can steer you clear from agencies that are not flexible when it comes to cancer survivors adopting and point you toward agencies who are more friendly toward the issue. A great group who would love to be an adoption resource for cancer survivors is Christian Adoption Consultants.


It’s Danielle again —

So as you can see, Nikki is a WEALTH of knowledge and there is HOPE for the cancer survivor who wants to adopt!

Stay tuned – we’ll have Nikki’s advice specifically for cancer survivors who want to internationally adopt and domestic adoption for cancer survivors coming up.

And – if you have a question for us, please leave a comment and we’ll address it in a future post!


Entry filed under: Adoption, Cancer Survivor. Tags: , , , , , , , .

Week Two Carried

7 Comments Add your own

  • 1. Sam  |  August 22, 2013 at 10:43 am

    Danielle – thank you so much for writing and for sharing all of this info. As a cancer survivor and adoptive mama (of two!) myself, I think it’s so important for adoption to be considered a choice in its own right — not a last ditch effort or a worst case scenario.

    The advice you and Nikki gave here is so right-on-the-money. Finding a social worker who will advocate for you and will take the time to really get to know your story is key. Back in 2007, when I first started thinking about family building, I had so many fears and worries about whether and how my cancer history would play in. I wish I had had this post back then!

    It’s so critical for cancer survivors to know that “being able to have children” and “being a parent” are not the same thing. Cancer may make certain things impossible – like starting a family the traditional way – but it doesn’t have the power to prevent us from starting families at all.

    So, again, thank you for this post. I just think you’re the greatest.


    PS If any of your readers would like even more info, The SAMFund hosted a Webinar last year about the adoption process (it was a two-part series on family building, the first of which focused on biological options and the second of which focused on adoption) and it’s archived here: Hope it’s helpful!

  • 2. Theresa  |  August 22, 2013 at 1:34 pm

    What are the costs associated with adoption? I am still making payments on medical debt and we want to start saving for this for the future

    • 3. Danielle B  |  August 22, 2013 at 2:05 pm

      Theresa – great question! The costs will vary based on the adoption route you choose! They can range from very minimal to not-so-minimal based on many factors. We’ll give into this topic with Nikki in an upcoming post – but thank you so much for the idea and question!

  • […] We kicked off our first post – Adoption After Cancer: What Are My Options? […]

  • 5. emily  |  January 6, 2015 at 11:39 am

    What about folks with chronic but low-maintenance cancers? All the articles I can find are about those in remission, but these folks should be allowed to adopt as well. They’re never considered in remission but only get treatment once a month or less and maintain full-time jobs and otherwise normal lives.

  • 6. Kimber  |  July 30, 2017 at 7:52 am

    Thank you so much for writing this article. I am a cancer survivor and my only regret in life would be not given the opportunity to be a parent. I was wondering how agencies look at those with multiple recurrences? This is over a 17 year span, with a increase in the pattern between recurrence, and caught at the smallest measurable point. I don’t know if it helps that I am only 37.

    • 7. Danielle B  |  July 30, 2017 at 7:16 pm

      Thank you, and congrats on your survivorship so much. Each agency is different on what they accept or don’t accept in terms of diagnosis and recurrence. For me, I worked with one that said I needed to be 1 year NED, and the recurrence didn’t make a difference. My doctor’s note signing off my “clear bill of health” and stating I was just as healthy as anyone else, and fully able to adopt, was the important thing for the court to see. It might help to call around and start asking agencies!


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