"It has to be taken into account that despite progress in medical science, cancer remains an unknown disease, for which no cause may be blamed. Such things as air pollution, genetically modified food or water contamination are known as predisposing factors of cancer, but none of them causes cancer per se," he added.

Samie said: "In the petroleum industry, to counter different diseases including cancer, many actions are under way in cooperation with health, insurance, environment (HSE) units and industrial medicine with a view to limit and contain pollution, and we are trying to reduce the impact of predisposing factors by providing healthy food and healthy environment for staff."

 

100% Insurance Coverage for Chemotherapy

 

Samie said Iran's petroleum industry was providing one of the most complete health insurance services at the national level. 

"Before the start of health revamp scheme in the 11th administration, application of basic insurance by minister of health, treatment and medical education [in the administration of President Hassan Rouhani] and provision of 90% coverage for chemotherapy, PIHO was offering 100% insurance for every kind of disease, healthcare and medical services for petroleum industry employees," he added.

"First-degree chemotherapy medications and other necessary medications for cancer are offered gratuitously at PIHO hospital sin Tehran and Ahvaz. In case the employees need subspecialized treatments like transplantation they are transferred to other centers like Shariati Hospital of Tehran with PIHI accounting for costs," said Samie.

"Even in cases where a patient is applying for bone marrow transplantation while there is no suitable donor, PIHO intervenes and pays for donation costs at Shariati Hospital and then the donor of bone marrow will be invited from anywhere in the world to Iran for transplant," said Samie.

"In the latest cases, bone marrow transplantation in leukemia cost about €80,000. It is a big figure, but it was paid," he added. 

"Normally, there are few cases where bone marrow transplantation is needed because the disease must first be contained and there would be a chance for match. In some cases, there is a chance for transplantation among family members without having to refer to bone marrow transplant global bank," said Samie. 

 

Containing Pollutants

 

Samie said there was no clear figure about the number of cancer patients in the world, noting that all of them had been identified. 

"In addition to presenting an in-house report about the number of patients and their treatment, we are required to provide updated data to the Center for Cancer Data Registration of Ministry of Health, Treatment and Medical Education," he added.

"The reason for imprecise data is that some patients do not refer to PIHO hospitals and healthcare centers and they directly receive services from public or private sector," Samie said.

"Cancer is a general word. Some patients may become healthy after a surgery operation for tumor removal. Some others see their health improve after several rounds of chemotherapy. Therefore, we don’t know whether or not someone who underwent treatment several years ago should be included in the data," he added.

"PIHO pays for all costs and insurance cover of all other diseases. There is no difference between special and non-special disease for this organization and we have 100% coverage," Samie said. 

Noting that there has always been misperception of remarks about pollutants in industrial centers and oil facilities, he added: "In addition to regulatory agencies in the country keeping a tab on pollutants, the World Health Organization (WHO) regularly monitors such cases. For instance, WHO placed alcohol on its carcinogenic list because it was proven to be an important factor in contracting this disease."

 

No Proven Leukemia-Workplace Link

 

Samie said: "Petroleum industry employees are regularly being trained and updating safety instructions. Measures pertaining to occupational medicine, periodic checkup and occupational match are being done."

"However, traumas are inevitable in an industrial environment and as we are faced with a variety of pollutants in Tehran. Someone who works in an industrial environment may be exposed to many such pollutants," he added. 

"For instance, benzene is said to be a material causing leukemia. Based on such argument, all those who work at gas stations and people living in surrounding areas may be exposed to such a threat, as is the case with petroleum industry employees. But all of these people are not supposed to have leukemia as there are many causes involved in leukemia and therefore we cannot blame leukemia on workplace," said Samie.

He said that occupational diseases have a scientific definition in medical sciences, adding that every disease could not be blamed on workplace.

"Neither in Iran's petroleum industry nor anywhere else in the world, it has been said that people in direct contract with benzene will contract leukemia," said Samie.

 

70% of Cancer Patients Refer to PIHO Centers

 

Samie said: "We advise cancer patients to undergo treatment at PIHO hospitals in Tehran or Ahvaz, but some of our patients are retirees who are in contact with public and private hospitals outside the petroleum industry. But if these patients are hospitalized in the best hospitals in Tehran we will cover them and they will only pay deductibles. However, more than 70% of our cancer patients refer to PIHO centers to undergo treatment."

 

Ministry Banks Dispatching Patients Overseas

 

Samie said administrative regulations banned petroleum industry patients from traveling abroad to undergo treatment.

"Pursuant to an instruction by Minister of Petroleum with regard to administrative regulations and healthcare affairs in September 2016, dispatching abroad for treatment does not lie within the purview of PIHO. It has been noted in the Minister of Petroleum's instruction that the Ministry of Petroleum will not pay for treatment costs in any other country. That lies with the Supreme Council of Dispatching Patients Abroad," he said.

"The criterion for the Minister of Petroleum's instruction is an announcement by the Ministry of Health, Treatment and Medical Education regarding the availability of treatment for all diseases in the country," he said. "Since Mr Qazizadeh Hashemi started his tenure as minister of health, treatment and medical education, no committee has been set up to send patients overseas the Supreme Council of Dispatching Patients Abroad deals with workplace accidents."

 

Macropolicies Favored Over Personal Views               

 

Samie singled out the case of a petroleum industry employee who had contracted leukemia and wanted to go abroad for treatment. "We received information about this patient and his treatment was started immediately at Shiraz Hospital. Later on, Pars Special Economic Energy Zone officials outline the conditions of the patient. Some doctors had advised sending him abroad and he had even sold his home for that purpose. The point is that there are macropolicies which are prioritized over personal views," he said.

 

Bone Marrow Transplant Possible in Iran

 

Samie said bone marrow transplant is not sophisticated to require special equipment. 

"The only issue with this treatment is to find a suitable donor. This problem could be resolved. Instead of sending the patient abroad, we can invite the potential donor to Iran. It is now possible in the country and there have been some cases," he added.

He acknowledged the difficulties with acute leukemia, saying PIHO would in line with existing regulations and laws make its best efforts to treat the aforesaid patient.

"As an internist with three years of experience at PIHO hospital dealing with cancer patients, and not as CEO of PIHO, I believe that nothing more is done outside Iran than inside Iran for treating such patients," he said.

Samie added: "We have had many such cases who have started treatment. I reiterate that we are ready to receive the aforesaid patient even if he returns now."