Iran’s Cancer Patients Need Affordable Drugs, the Latest Equipment—And Education

Being diagnosed with cancer is often devastating and traumatic. Patients and their families can find themselves overwhelmed by information, advice, unfamiliar medical terms and a schedule of terrifying treatment options. In many countries, patients can be somewhat reassured by the fact that their doctors are able to give them the most advanced treatment available and provide them with adequate advice on how to cope with what can be a debilitating illness. But in Iran, where the number of people diagnosed with cancer is on the rise, this is often not the case.

Years of sanctions have taken its toll on the country’s healthcare system. Although sanctions imposed on Iran do not apply to the supply of medical goods, bans on banking transactions and currency exchange has made delivery of medical supplies increasingly difficult. Government cutbacks in public services and key industries to deal with the impact of sanctions have had a detrimental impact on hospitals, the pharmaceuticals market and the ability of medical professionals to do their jobs well.

For cancer patients, this can mean a lack of access to the treatments, education and equipment that can help them most.

One of the most effective technologies for identifying exactly where a cancer is in the body and what organs have been affected by it– and differentiating it from scar tissue–is the Positron Emission Tomography (PET) scan. Even in wealthy countries, these machines are few in number. Thanks to charitable donations, Iran's first PET scan facility was installed at the Massih Daneshvary Hospital in Tehran in March 2013.

IranWire spoke to a nuclear medicine specialist about this advanced medical technology and its potential impact. He said PET scans are one of the most accurate ways of identifying the exact location of cancerous tissues and helps radiotherapy professionals sucessfully target cancer cells. Because of its accuracy, PET scans help reduce unwanted side effects of cancer drugs. 

Yet when PET scan technology was introduced to the hospital, officials reported that a cyclotron had been brought in to boost production of the nuclear medicine (or tracers) the hospital needed. According to them, cyclotron technology would create "four times" what was actually required by the hospital and its patients. What happened to the cyclotron and why is this important technology being left out of cancer treatments in Iran? And why are tracers so rare?

Daniel Tohidi's Cancer Awareness Campaign

In 2010, the mother of Iranian sailing champion Daniel Tohidi was diagnosed with breast cancer. She received treatment and went into remission, only to be diagnosed with liver cancer a short time later.

Since then, the athlete has worked hard to promote education around cancer, as well as finding out just why essential drugs like tracers are so difficult to access in Iran.

After learning about the benefits of PET scans, Tohidi found out that two pharmaceutical companies manufactured the tracer; one brand cost around $500 and the other about twice as much. “I thought the cheaper brand must be lower quality,” he told Iranwire. But it turned out that the reason for the vast difference in price was to do with the way the drug was distributed in Iran.

Because his mother needed the treatment as soon as possible, he decided to order the more expensive brand, but 20 days after paying for it, the hospital had still not received the medicine. Staff at the hospital also said that they didn’t know when the cheaper version of the drug would be available.

IranWire contacted Massih Daneshvary Hospital to find out about the medication and why there was such a problem ordering it. A hospital spokesperson said the drug was currently unavailable but that a patient was entitled to a refund if it did not arrive. The spokesperson refused to answer further questions, saying the hospital was too busy to talk to the media.

In Iran, PET scans combined with radiotherapy treatment costs between $2500 and $3000, according to the nuclear medicine specialist IranWire interviewed. But in Turkey, the United Arab Emirates and a handful of other countries, the treatment costs a lot less. In recent years, “Iran has lost professionals, artists and sportspeople” because the opportunities in Iran are so limited, says Tohidi. According to one medical student studying abroad, opting for a medical profession in Iran is a huge financial burden, not only because it’s badly paid for most, but because it’s extremely difficult to build a career in a profession that is essentially controlled by small, well-connected, elite groups of people.

 “Iranian cancer patients and their families often complain about long and costly treatments and the high prices of scarce drugs,” says Tohidi. Patients who can leave the country to seek medical attention elsewhere do so on a regular basis. Just as Iran has been unable to support its professionals, an under-resourced and underperforming medical industry is pushing Iranians with serious illnesses out of the country too.

Education is Key

Since his mother was diagnosed with cancer four years ago, Tohidi has become an advocate for health education, committed to teaching the public about cancer and how it can be prevented.

As part of his campaign, he regularly sails around the coast of the Caspian Sea and teaches villagers the most effective ways of preventing cancer. The Iranian National Cancer Society has paid tribute to Tohidi’s work, appointing him “ambassador-at-large” for the cause.

But despite this recognition, Tohidi is frustrated by the lack of education about cancer and the ways it might be prevented.

“Why has fighting cancer has been reduced to its treatment and cure?” Tohidi asks. “And why are we not teaching people how to prevent it? In the world of treatment, money talks, whether through the drugs industry or modern equipment sales. But wheeling and dealing does not enter into teaching how to prevent cancer...Stress and fear are important factors in the spread of cancer cells. It follows that maybe making cancer patients happy and motivated is the best way to control the disease.”

The situation for cancer patients and others needing urgent medical attention is not new. And, according to the head of Iranian Medical Specialists Society, it’s getting worse. “The number of cancer patients in the country is growing by 10 to 20 per cent each year,” he said at a recent press conference. Based on this trend, there will be 400,000 cancer patients in Iran by 2015.

It’s essential the Iranian government find some way of offering these patients reliable treatment at an affordable cost. With some sanctions being eased in response to nuclear negotiations and a new government in place, the economy could be on the way to a partial recovery and banking transactions could be restored to some extent. Yet accusations of corruption and a legacy of bad management suggest the battle will be a long one. And crucially, as Tohidi and other campaigners well know, educating Iran’s people about cancer prevention must begin now.