When the wife of exiled Iranian Crown Prince Reza Pahlavi went public with her breast-cancer diagnosis, thousands of Iranians flooded social media with messages of support. And in a country where public discussion of cancer is still considered rare, it was her openness that was praised by many on social media.
Yet there was also criticism of her husband's support for the hard line the administration of U.S. President Donald Trump has taken on Iran, which includes the reimposition of tough economic sanctions that, according to Iranian officials, have negatively affected access to medicine and health care.
Yasmine Pahlavi, 50, made the announcement last week in an online video. She said that despite being a private person, she had decided to use Instagram, one of the very few social-media sites that remain unblocked in Iran, to document her fight with cancer in the hope of raising awareness among her compatriots, particularly women and girls.
"I hope my illness becomes an opportunity for us all to learn more about women's health and breast cancer," the mother of three said in a November 28 video, where she noted that women in Iran are generally reluctant to speak about their bodies.
"I believe we must pay greater attention to this illness and other diseases that threaten the lives of hundreds of thousands of Iranian women," she said.
'Shocking' Lack Of Education
Cancer remains a taboo subject for many in Iran, where health issues are considered highly private.
Sogand Afkari, an Iranian-American who works in the travel sector in Iran, says she experienced breast cancer through her aunt, who was diagnosed about two years ago and is now in remission. "The first thing that shocked me was the lack of information and education around breast cancer in Iran," Afkari, who is based in Iraq, tells RFE/RL.
"My [aunt] did not realize she had breast cancer until she was watching an episode of Doctor Oz," she says, referring to a U.S. talk show that focuses on health. "They taught her that she has to check her breasts."
Iranian health officials say the prevalence of breast cancer in Iran is lower than in Western countries, while the mortality rate is the same. (According to official Iranian statistics, 30 women out of 100,000 are diagnosed with breast cancer. In the United States, the Netherlands, and France, over 90 out of 100,000 women are affected.)
According to local health officials, Iranian women are often diagnosed with late-stage breast cancer -- when the tumor is more difficult to treat and is more likely to have spread -- due to a lack of awareness about the need for preventative screening.
A member of the board of directors of Iran's Association for Female Cancers, Azamolsadat Mousavi, said in a 2017 interview that breaking the taboo and raising awareness was the most important issue regarding breast cancer in the country.
A woman in Tehran who lost her mother to breast cancer says Pahlavi deserves praise for her effort. "I'm not a monarchist but I respect Yasmine Pahlavi for speaking publicly about her cancer. For a long time, my mother refused to even talk about it. She was reluctant to use the word 'breast cancer' and would just call it her 'disease.' There is a stigma," the woman, who did not want to be named, tells RFE/RL.
"What [Pahlavi] has done is valuable. It could lessen the fear and concern over [breast cancer] for many," a user commented on Instagram.
"This announcement could be a wake-up call for women who don't take their health seriously," another said.
No Hiding From Politics
Pahlavi, however, has also been accused by some Iranians of using her condition to push the agenda of her husband, Reza Pahlavi, who's taken an increasingly active political role in recent months, calling for an end to the Islamic republic and the establishment of secular democracy in the country.
Reza Pahlavi's father, Mohammad Reza Pahlavi, was toppled by the 1979 revolution that led to the creation of an Islamic republic. Reza Pahlavi has since lived in exile with his family.
The shah of Iran (left) with his wife and sons Crown Prince Reza on right) and daughter shown during their stay in the Bahamas in April 1979.
Travel worker Afkari says Pahlavi's effort to raise awareness about breast cancer can't be separated from her husband's support for U.S. policies on Iran. "The people can't exercise their own self-determination when they're grappling with sanctions," she says.
"She could be making such a claim to portray herself as brave and strong and reasonable. Anything is possible from this undemocratic family," a commenter on Instagram said.
Others suggested that Pahlavi should push for the removal of U.S. sanctions, which they said had made access to medicine and treatment increasingly difficult for Iranians inside the country. Trump withdrew from the 2015 nuclear deal in May and announced the reimposition of sanctions that target Iran's economy, including its banking and oil sectors.
"If you really want to express solidarity, stop the sanctions on medicine so that people don't face problems. My father has diabetes. Today we went to three hospitals to do a test and were told they don't have the kit," an Instagram user said.
"Imagine what those who suffer from cancer and other untreatable diseases go through," the user added.
The United States says it has never targeted medicine or food. "Our sanctions do not now, nor have they ever, targeted humanitarian goods. Our sanctions pressure the Iranian regime into changing its behavior and they do not target the Iranian people. The United States does not sanction the export of food or medicine to Iran," Brian Hook, the U.S. special representative for Iran, said in a July briefing with journalists in Washington, D.C.
Iran has said that the sanctions, which have contributed to the crash of the national currency, the rial, and restricted financial transactions, have also had a detrimental effect on the country's health-care sector.
Last month, in a letter to UN Secretary-General Antonio Gutteres, Iran's Medical Council said that U.S. economic sanctions "have seriously affected the ability to access health services and treatment, medicine and medical essentials."
Domestic mismanagement and hoarding has also been blamed for the rising prices and shortages of some medicine. An official at a pharmaceutical company in Tehran who did not want to be named tells RFE/RL that "medicine produced inside the country needs raw materials from outside."
In some cases, she says, the price of medicine has doubled or tripled.