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Deadly Thai diet: Doctors battle cancer-causing fish dish

Agence France-Presse / 11:27 AM June 28, 2017


This photograph taken on May 20, 2017 shows a farmer chopping fresh fish for lunch in the northeastern Thai province of Khon Kaen. Millions of Thais across the rural northeast regularly eat koi pla — a local dish made of raw fish ground with spices and lime. The pungent meal is quick, cheap and tasty, but it is also a favorite feast for parasites that cause a lethal liver cancer killing up to 20,000 Thais annually. AFP

KALASIN, Thailand — 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.

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Once eaten, the worms can embed undetected in the bile ducts for years causing inflammation that can, over time, trigger the aggressive cancer, according to the World Health Organization.

“It’s a very big health burden around here… it effects 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.”

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Karma and convenience

Many villagers are shocked to hear that a beloved dish passed down for generations is a danger rather than a comfort.

Others are wedded to the convenience of a thrifty lunch they can whip up using fish caught in the ponds that border their rice paddies.

“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, licking his lips as he sprinkled seasonings into a bowl of the finely-chopped fish’s pink flesh.

Since learning of the cancer link he has started frying the mixture to kill off the parasite — a method doctors recommend.

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Catch it early

When it comes to changing eating habits, health officials are pinning their hopes on the next generation, targeting children with a new school curriculum that use cartoons to teach the risks of eating raw.

For the elderly, the target is to catch infections before it’s too late.

Narong and his team have developed urine tests to detect the presence of the parasite, which has infected up to 80 percent of some Isaan communities.

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The group ticked off a series of high-risk factors: they were over the age of 40, had a history of eating raw fish and had family members with the cancer.
A third of them showed abnormal liver symptoms and four were suspected to have cancer.

Thanin was one of the lucky ones, emerging from his ultrasound with a look of relief.

“I don’t think I will eat (koi pla) raw anymore,” he told AFP with resolve. As for his neighbors?

“They will not quit it easily.” CBB

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