If fertility treatments or surrogacy aren't good choices for you and your unique situation, then you may want to consider adoption.

In the United States, there are three main ways to adopt:

Private domestic adoption: adoption of a child from the United States who hasn't been taken into custody by the state. Private domestic adoption can be done through an agency or an attorney. According to Gina Shaw, author of Having Children After Cancer, four states — Colorado, Connecticut, Delaware, and Massachusetts — require you to use an agency for adoptions and do not allow adoptions managed by an attorney.

Domestic adoptions can be open, which means the birth parent(s) have contact with the adoptive family and the adopted child; semi-open, which means the birth parent(s) have limited contact with the adoptive family, sometimes only through a third party, such as the adoption agency or an attorney; or closed, which means neither the birth parent(s) or the adoptive parents know anything about the other and there is no contact.

International adoption: adoption of a child from a country other than the United States. To adopt internationally, you have to go through an accredited agency. Many parents who adopt internationally try to maintain some type of contact with child's birth family, if possible.

Foster-adoption: adoption of a child that has been taken from the birth parent(s)'s custody by state authority. In some cases, the child may be placed in your care as a foster child while the state considers whether the birth parent(s) can eventually regain custody of the child. In other cases, foster children are able to be adopted because the birth parent(s)'s rights have been removed. These children are usually older.

To help you decide which type of adoption is right for you, Gina Shaw has developed the following questions to consider:

  • What do you picture your future child and family looking like? How attached are you to that specific picture?

  • How important is it to you (and your partner, if you have one) to parent a newborn or very young baby?

  • How do you (and your partner, if you have one) feel about open adoptions? What degree of openness are you comfortable with?

  • What are your extended family's opinions of adoption? If they're negative, how would you educate them? If they're not open to the information you give them, what would you then do?

  • Would you be comfortable parenting a child of another race or ethnicity? Do you have the resources and are willing to spend the time to make sure the child is connected to his/her heritage?

  • Can you take time off work to travel to and spend time in another country to visit and bring your child home? (Most countries require two or more trips.)

  • How difficult would it be for you to parent a baby or child for several months and then have to return the child to the birth parents if the foster plan called for that?

  • What is your budget for adoption? Does your company have any programs to support employees who adopt?

  • Would you feel comfortable adopting an older child? Are you ready for the additional challenges that come with a child who has been in the foster system for a while? How will you learn about these issues?

  • How soon do you hope to bring home a child?

All prospective adoptive parents, no matter what type of adoption they choose, must go through home study, a process where a social worker or other professional visits your home and then interviews you, your partner, and anyone else who lives in the home, about your life, your parenting philosophy, and other things that help adoption professionals decide if you're worthy of being entrusted with the life of a child.

It can take from a month to 6 months or more to go from the start of the home study process to being approved to adopt. If you're adopting from foster care, you'll also probably have to take a series of classes.

A medical form is part of every home study. Almost all of them ask if you've had a life-threatening illness such as cancer. Answer the question truthfully — lying can end your chances of adopting.

Your doctor will have to fill out a form with your diagnosis, treatment, and prognosis. Many of the forms are very general and brief — if yours is, ask your doctor to write a more detailed letter. You want a very supportive letter from your doctor, explaining your diagnosis, your treatment, and how you responded. Here are some tips on what to ask your doctor to put in the letter:

  • If you have no evidence of any remaining cancer and your life expectancy is normal, ask your doctor to say that.

  • Ask your doctor to write the letter in common language — no medical jargon and no abbreviations.

  • Ask your doctor to use the words "cancer-free" and "normal life expectancy" in the letter, if both of these apply to you. Many adoption agencies look for these terms.

  • Ask your doctor to include any statistics that can support your normal life expectancy. This may include statistics on how your particular treatment works on the type of breast cancer with which you were diagnosed.

Because doctors are busy, it's a good idea to write a first draft of the letter yourself and bring it to your doctor's office on a portable flash, thumb, or key drive. Bring it to your next appointment and go over the letter with your doctor. Your doctor can make corrections or additions, print it out on letterhead, and sign it right then so you can take it with you.

Once you have a positive doctor's letter and have been finished with treatment for at least 1 year (this time period varies from agency to agency), it's likely that your home study will be approved, if there are no other issues.

The costs of domestic adoption range from less than $10,000 to $30,000 or more. International adoption costs more because you pay all the same fees as domestic adoption, plus fees mandated by the country you're adopting from and the cost of multiple trips to the country.

Adopting from foster care is much less expensive. In most cases, there is no charge to adopt a foster child. If the child lives with you as a foster child, you'll probably receive a monthly check from the state to cover some of the child's expenses. If you adopt a child with special needs, there's usually additional support and some states may continue the support after the adoption is finalized.

— Last updated on February 2, 2022, 5:02 PM