Is it possible to adopt a child for someone who has had cancer? And after how long? The issue was brought to the attention of the news in recent days by the actress Carolina Marconi, who had breast cancer last year. In a post on Instagram Carolina tells that she and her partner are followed by a lawyer. But she, she writes, “unfortunately I am not eligible to undertake an adoption because I had a tumor”. And she invites you to sign up to support the initiative #iononthis myotumor of the Aiom Foundation on the rightallobliotumori.org website, to ask for a law to be established on the right of former patients to no longer be considered sick.
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Let’s try to clarify in the Breast Health newsletter on what the medicine (and the law) says with Giordano Berettaoncologist and president of the Aiom Foundation, ed Elisabetta Iannellilawyer and Secretary General of the Favo- Federation of Voluntary Associations in Oncology.
Adoption and former cancer patients
The first message to pass to avoid confusion is that there is no law prohibiting adoptions for those who have had cancer and are considered cured: the requirement of common sense is that there is no concrete and immediate risk for the survival of those who aspire to become parents. “The planning of having a child is a hope of life and a human desire, but we must always keep in mind that the first right to be protected is that of the minor to have a family”, explains Iannelli:
“When there is a condition of long survival after diagnosis without recurrence, there is no reason why the suitability for adoption should not be recognized. Each case must therefore be assessed on its own, but in general there are no impediments. legitimate or ethical, and in Italy there are women and men who became adoptive parents after cancer “.
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When to apply
There is no deadline established by law and the question is also at the center of comparisons on a scientific level. “As a rule – continues Iannelli – the Juvenile Courts take 5 years as a reference, although it is not clear whether from the diagnosis, from the latest evidence of illness or from the end of the treatments. Today it is up to the sensitivity of those who are called to decide. For this we need clear indications for the Juvenile Courts, based on guidelines, so that the judges can have shared criteria “.
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Former patients, what science says
By healing, in oncology we mean the period after which life expectancy returns to be the same as in the general population. And establishing the time it takes for this to occur is scientifically difficult.
“Today cancer can be cured and this is a very important message”, Beretta is keen to underline. Each type of tumor, however, has its own times: there are tumors for which one can be considered cured after two years from diagnosis, and others for which it takes more than 20 years.
It all depends on the tumor
“Speaking of breast tumors – explains the oncologist – by now we know well that they are not all the same. In the case of carcinomas in situ, for example, one can be considered free of the disease after two years. Others, such as triple-negative or HER2-positive tumors are very aggressive, so the probability of the disease returning is high, but only within the first 5 years of diagnosis: after this period, the risk drops. Then there are the hormone-sensitive tumors, the most frequent: in these cases it is true that a residual risk of recurrence persists for many years, but it is also true that only a small percentage of women will become ill again. However, it is necessary to evaluate case by case, keeping in mind the state of the current disease and not a possible future disease “.
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Cancer and adoptions: what is there to change
In Italy there are about 3.6 million people who have had a diagnosis of cancer in the past: of these about 900 thousand are considered clinically cured and for them there should be no form of discrimination. As for the others, as mentioned, we are in a large gray area, where chronic patients are also found. One of the objectives of patient and medical associations is to ensure that they too can see the right to adopt children recognized.
What is a law on the right to be forgotten for?
The law on the right to be forgotten that we want to propose, for which the Aiom Foundation has launched a collection of signatures, concerns first of all the financial and insurance world: it aims to establish a limit, equal for everyone, after which no one has plus the right to ask a person about their ‘oncological past’.
“The first objective of the law, for now, is to give a certain timing – says Beretta -. We want to set this limit on the basis of what happens in other European countries: 5 years after the end of treatments for former pediatric patients and 10 years for former adult patients. With this first milestone, we will take a next step, specifying shorter healing times in cases where the conditions exist, in order to guarantee further rights, such as that for adoptions “.
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What is the adoption process today?
As explained in Aimac’s booklet “Mother after cancer and preservation of fertility”, where a chapter was dedicated to adoption, the procedure for obtaining eligibility is however long and complex. The application must be submitted to the Juvenile Court through a lawyer. From that moment the phase of the investigations necessary to ascertain the requirements begins: the state of health of the spouses, the family environment, the reasons for which they wish to adopt. At the end, the competent Juvenile Court will receive the final psycho-social report. “The investigation – concludes Iannelli – can take a long time, with a thorough evaluation of the medical and psychological aspects, but the way in which the family has dealt with the disease could even represent an advantage in the eyes of the magistrate who will be called to establish the eligibility”.