Deadly diet: Thai doctors battle cancer-causing fish
IT WASN’T until he got to medical school that Narong Khuntikeo finally discovered what caused the liver cancer that took both of his parents’ lives: their lunch.
Like millions of Thais across the rural northeast, his family regularly ate koi pla – a local dish made of raw fish ground with spices and lime.
The pungent meal is quick, cheap and tasty, but the fish is also a favourite feast for parasites that can cause a lethal liver cancer killing up to 20,000 Thais annually.
Most hail from northeastern Isaan, which now has the highest reported instance of the Cholangiocarcinoma – bile duct cancer – in the world.
One of the major causes of CCA is a parasitic flatworm – or fluke – which is native to the Mekong region and found in many freshwater fish.
Once eaten, the worms can embed undetected in the bile ducts for years causing inflammation that can, over time, trigger the cancer, according to the World Health Organization.
“It’s a very big health burden around here . . . it affects families, education and socioeconomic development,” said Narong, who went on to become a liver surgeon to battle the scourge.
“But nobody knows about this because they die quietly, like leaves falling from a tree.”
After seeing hundreds of hopeless late-stage cases on the operating table, Narong is now marshalling scientists, doctors and anthropologists to attack the “silent killer” at source.
They are fanning out across Isaan provinces to screen villagers for the liver fluke and warn them of the perils of koi pla.
But changing eating habits is no easy task in a region where love for Isaan’s cuisine runs deep.
“I used to come here and just catch the fish in the pond . . . it’s so easy to eat raw,” said Boonliang Konghakot, a farmer from Khon Kaen province.
Since learning of the cancer link he has started frying the mixture to kill off the parasite – a method doctors recommend.
Yet not everyone is as easily swayed, according to Narong and his team.
Some simply shrug off the dangers and say their fate has already been fixed.
“They’ll say: ‘Oh well, there are many ways to die,’” lamented Narong. “But I cannot accept this answer.”