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Thai doctors fight a dish of carcinogenic fish

Ⓒ AFP – Lillian SUWANRUMPHA – | Thai farmer prepares raw fish dish in Khon Kaen, northeast of Thailand, May 20, 2017

Narong Khuntikeo discovered the cause of liver cancer, which took his two parents away, a fish dish from northern Thailand that they loved.

Like millions of inhabitants of Issan, a rural area in the northeast of the kingdom, his family regularly cooked “Koi Pla”, a traditional dish made with raw fish, lemon juice and spices.

This dish with a strong smell and taste is rapidly prepared and cheap, but the fish used is often the carrier of a parasite that causes liver cancer, cholangiocarcinoma.

Ⓒ AFP – Lillian SUWANRUMPHA – | Examinations for liver cancer screening in Kalasin province, northeast of Thailand, May 19, 2017

This aggressive cancer causes 20,000 deaths each year in Thailand, a country that holds the world record for this disease, rare elsewhere in the world.

It affects 84 men out of 100,000 in Thailand, compared with 1 in 100,000 in the United States, for comparison. In Thailand, most of the patients are from this poor region of Issan.

The parasite is frequent in the waters of the Mekong basin. Once ingested, the worm can live for years in the liver of the individual, without being noticed, but it causes an inflammation of the liver often degenerating into cancer.

Ⓒ AFP – Lillian SUWANRUMPHA – | Screening for liver cancer is developing since, since last year, the health authorities of Thailand have made this problem a national priority

“This is a serious health problem here … It affects families, but also socioeconomic development,” says Dr. Narong Khuntikeo, whom his family drama led to specialize in liver surgery.

“But no one is aware of it, so people die silently, as the dead leaves fall from the trees,” said the doctor from Khon Khaen University, tired of seeing the inhabitants, often uneducated rice farmers, consult In the terminal phase.

– Prevention campaign –

He and doctors and scientists traveled through the villages of Issan to warn the population against the consumption of this dish.

But changing the eating habits in this region to gastronomy largely based on this type of dishes made from fermented fish and spices is not easy.

Ⓒ AFP – Lillian SUWANRUMPHA – | Cholangiocarcinoma, a parasite that causes liver cancer, is common in the waters of the Mekong Basin in northeastern Thailand

Some believe that cooking alters the taste of the dish, others claim the Buddhist precept that it is necessary to bend to its destiny, and that if one must die from liver cancer, it is vain to try to d To escape.

“I can not accept this answer,” laments Narong Khuntikeo.

Some, however, are sensitive to the message. Among them, Boonliang Konghakot, a peasant from the region, who cooks the fish since the doctors explained that it killed the parasite.

Ⓒ AFP – Lillian SUWANRUMPHA – | Liver cancer affects 84 men out of 100,000 in Thailand, compared with 1 in 100,000 in the United States

“Before, I caught the fish in the pond … Then it was so easy to eat raw fish,” he explains, near a reservoir of water dug between the rice paddies.

Screening is expanding because, since last year, the health authorities of Thailand have made this problem a national priority.

A program, called CASCAP (for Cholangiocarcinoma Screening and Care Program), was launched at the University of Khon Kaen, Issan’s big student city. Examinations are now being organized in the villages of the region to prevent patients from arriving too late in the oncology services.

Ⓒ AFP – Lillian SUWANRUMPHA – | Millions of inhabitants of Issan, a rural area in northeastern Thailand, regularly cook “Koi Pla”, a traditional dish made with raw fish, lemon juice and spices

“I’ve never been tested for this yet. I think I have to be infected because I’ve been eating it (from the Koi Pla) since I was a kid,” says Thanin Wongseeda, a 48-year-old farmer Its turn for a free consultation organized in the province of Kalasin.

Of the 500 villagers examined that day, one third had liver problems and four were diagnosed with a probable cancer.

Thanin sighs at ease after leaving the consultation: the ultrasound has revealed nothing suspicious. Relieved, he assures: “I will not eat raw fish anymore.”

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