Udon leads world in Liver Fluke cancer

The Nation 08/11/10 http://testeng.ksp.or.th/rule.php

I certainly didn't know this.. I always thought Sakon Nakhon had the highest liver fluke infestation in Thailand

Udon Thani has the worst rate of liver-fluke cancer in the world, say doctors treating the Kingdom's most dangerous form of cancer - which kills 50 Thais a day or 2 people every hour. "Cholangiocarcinoma" is one of two types of liver-fluke cancer and "kills 90 per cent of the time," Dr Bancha Tanchavalit, from the Udon Thani Cancer Centre, says.About 15,500 die from every year, mostly people in the Northeast. But Udon's toll is much higher. "Here, 110 out of 100,000 men contract it. For women, it is 70-80 per 100,000 [people]." The nationwide breakdown is 80 men per 100,000 and for women, the figure is 40. Only 10 per cent survive because they detected the disease early. But these are rare as symptoms usually don't show up until the final stages.

The chief culprit is a microscopic parasite called "opisthorchiasis viverrini", which becomes imbedded in the liver after victims consume raw fish from rice fields and ponds. The parasite, however, is not found in seawater fish. "Pain on the right side of the abdomen, loss of appetite, a low fever and jaundice are telling signs," he says. "Often they are also mistaken for something else." Without treatment, the patient is dead within three to six months. The only chance of survival is to surgically remove infected parts. "That extends life for a year or two. In a few cases, they may live five years." Bancha says. But chemotherapy and radiation were useless against the disease.

There are 55,000 cases of all types of cancer every year in Thailand. "Liver fluke cancer makes up a third of these cases," says Dr Thiravud Khuhaprema, head of the National Cancer Institute, based in Bangkok.
"The forecast for next year is 74,000 cases," he says. "Cholangio-carcinoma cancer is expected to rise correspondingly."
So concerned are doctors that a multi-million baht campaign with help from schools and village volunteers has begun, with sponsorship support from Bayer Thai, a leading pharmaceutical company.


Bayer Thai believes the many community events and nationwide media programmes including TV advertising will create awareness and lower the death rate.


"The best way to fight it is to prevent it," says a volunteer.


This cancer is largely due to eating contaminated fish. "All cases found the same parasite."


By targeting students, doctors hope youngsters may teach parents to eat only cooked fish, which is safe as intense heat kills the parasite.


The cost of prevention is also less costly than treatment.


"Surgery takes four and five hours," says Bancha who has fought the cancer for 30 years. "The bill is between Bt40,000 and Bt50,000, often beyond the means of many sufferers."


Worse, there are few surgeons who can operate on them. "In Udon, there are less than 10 doctors who can perform the operation."


Another culprit linked to this cancer is "Nitosamine", a carcinogenic agent directly involved in causing cancer.


Nitosamine is commonly found in fermented fish sauce and fermented proteins and pickled fish and meats.


"To make fermented fish sauce safe, all you have to do is boil it," says Bancha. "But not all sellers do this."


Adding to the problem is ignorance and misinformation.


"The myth is the parasites and carcinogens can be killed by drinking lots of alcohol like whisky.


"Another is they believe marinating lime into raw fish kills them. But these are proven by tests to be completely untrue."


Bancha says many farmers admit knowing that eating raw fish and unsafe fermented fish sauce is risky and can lead to cancer.


"But they stubbornly refuse to give up this culinary culture, which is deeply ingrained in Isaan."


Medical authorities and Bayer Thai have worked to increase awareness through campaigns in 19 Northeast provinces.

had an American friend get liver fluke infestation. Symptoms as outlined; abdominal pain, slight fever, weakness and jaundice (yellow skin and eyes). He got immediate medical attention getting a noxious concotion that killed the flukes. that was about 5 years ago and he's had no other problems... So, immediate medical attention can deal with the issue.. So, if you note some of your Thai kinfolk that just love the raw fish (or partially cooked) exhibitng symptoms get them to a clinic...

Thats amazing! Mrs Mortiboy,eats that orrible stuff "PALA". Would that be same same?......Stinks to High heaven!
I think fermented shrimps ect!.......orible orible orible ugh!

i'm glad I haven't ate any fish at udon,or any fermitted sauce either.I think after people read this they might stop eating this stuff also.

this type of liver fluke infestation is gotten by eating uncooked or partially cooked fish.. The fish contain the flukes and the flukes are killed if the fish is cooked thoroughly. The large lake east of Sakon Nakhon is infamous for having fish infested with the liver flukes. My friend that got them was traveling in northern Laos and ate uncooked fish at a hill tribe village.. Bla Ra or Bla Tek if properly prepared would not have the flukes. Pla Ra/Pla Tek is basically heavily salted/fermented fish.. Before refrigeration, it was a food that could be held in clay jars for months.. Yup, it's some nasty smelling stuff and akin to caviar for some Issan folk.