Jun 25, 2013
An interview with 2011 LIFe recipient and 2009 IDEA recipient Parisa Karimi, MD
AC: How would you describe the current state of cancer care in Iran?
Dr. Karimi: Iran has a population of 75 million—a large portion of which is under age 30. Cancer is the third most common cause of death after coronary heart disease and road traffic accidents, and in recent decades, the mortality of cancer has increased. The most common cancers in Iran (except skin cancer) for males are stomach, esophageal, colon-rectal, bladder, and leukemia; for females, breast, esophageal, stomach, colon-rectal, and cervical. Furthermore, the northeast region of Iran has one the highest rates for esophageal cancers worldwide.
The Comprehensive National Cancer Control Program (CNCCP)—a national cancer plan established in Iran in January 2007—consists of multidimensional approaches to cancer, including prevention, early diagnosis, and effective treatment and palliative care programs.
AC: What led you to pursue oncology as a career?
Dr. Karimi: As a medical doctor, I am interested in understanding the mechanisms of chronic diseases and providing appropriate treatment. High prevalence, mortality, and morbidity, as well as difficulties with recent treatments for different cancers, are factors that led me to focus on this disease.
AC: In 2011, you were awarded a Conquer Cancer Foundation Long-Term International Fellowship (LIFe). What did you investigate during this fellowship year?
Dr. Karimi: I researched the role of opioids on bladder cancer, which is a challenging topic in my home country. Recent research has shown that the number of patients with bladder cancer has risen year after year, and incidence is much higher than in other countries. According to a United Nations 2005 World Drug Report, Iran has some of the highest numbers of people addicted to opiates, and opiate addiction is a well-known risk factor for bladder cancer. Moreover, in 2006, the World Drug Report and the United Nations Office on Drugs and Crime indicated that more than 2.1 million Iranians (2.8% of the population) are addicted to opiates.
AC: How has the LIFe program furthered the development of cancer care in Iran?
Dr. Karimi: Basic research, especially in bladder cancer, is in its early stages in Iran and learning about recent breakthroughs in this disease area has been crucial for my home institution. Additionally, taking part in this fellowship has been a great opportunity to exploresome of the difficulties that our team experiences in both clinic and research labs. Since the project focused on two big challenges—addiction and bladder cancer—this experience has brought significant advantages to our research group to run similar projects. Knowing about recent investigation methods in basic research of bladder cancer has also contributed to improvements in our patients' treatment. There are many success stories in Iran about scientists who have passed a training program/fellowship in other nations and set up a new branch of research after returning to their home country—to me, this is such a positive step toward transferring skills and knowledge.
AC: What impact did your 2009 IDEA have on your professional development and your ability to affect care in Iran?
Dr. Karimi: As an IDEA recipient, I had the privilege to witness an oncology research lab at the Helen Diller Family Comprehensive Cancer Center UCSF. The research lab experiments were not routine in my country, and it was an invaluable experience for me. The IDEA has assisted me in enhancing my professional network, learning more, and moving forward in my career.
AC: What do you see as ASCO's role in supporting cancer research and care in your region?
Dr. Karimi: I believe the Society's effect is most significant in developing countries with limited resources and facilities. Through different programs, ASCO successfully improves cancer care and prevention, advances the education of professionals, and supports clinical cancer investigators' research and professional development. ASCO also fosters communication among cancer-related medical subspecialties and facilitates the exchange of ideas related to cancer. Furthermore, the Society's public policy advocacy efforts to ensure patient access to high-quality cancer care and assisting oncologists in addressing the challenges of the modern-day practice of oncology are examples of ASCO's achievements.
AC: Is there anything else you would like to share?
Dr. Karimi: I would like to thank ASCO for giving me this fabulous opportunity, and my mentor, Dr. David M. Berman, of Johns Hopkins University, for his kind support during my LIFe fellowship.
The last point I would like to mention is my concern about patients with cancer in Iran. Several sanctions have been imposed against Iran in recent years by Western countries because of political differences. Although medical and pharmaceutical equipment do not fall under these sanctions, Iran is still facing drug shortages for the treatment of several chronic illnesses, including cancer, because of restrictions in using the international payment systems. Like any medical professional, patients' health and safety are my first priorities. I hope these issues can be alleviated in the near future so that physicians in Iran can provide patients with cancer the best available treatment options.