Udon Thani Has Highest Rate Of Liver-Fluke Cancer In World: Thai Doctors

[webfact]

Udon Thani has highest rate of liver-fluke cancer in world

By Itthi C tan

The Nation

Udon Thani

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

-- The Nation 2010-11-07

[canuckamuck]

Wow shocking stats, A government campaign of awareness with a few clever commercials and banning uncooked fish sauce would save quite a few, but I don't expect that will occur.

[craigt3365]

Wow shocking stats, A government campaign of awareness with a few clever commercials and banning uncooked fish sauce would save quite a few, but I don't expect that will occur.

Read the last 3 lines:

-----------------------------------------------------------------

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

-----------------------------------------------------------------

I cringe when I head to Issan and watch them eat raw beef and pork. I try to explain the problems, but they just eat it anyway. Won't let wifey and her mother eat it anymore....

[tomyummer]

I've also heard some nasty things about 'nam', the fermented pork sausage.

[whybother]

Wow shocking stats, A government campaign of awareness with a few clever commercials and banning uncooked fish sauce would save quite a few, but I don't expect that will occur.

Read the last 3 lines:

-----------------------------------------------------------------

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

-----------------------------------------------------------------

I cringe when I head to Issan and watch them eat raw beef and pork. I try to explain the problems, but they just eat it anyway. Won't let wifey and her mother eat it anymore....

That's the same as smoking isn't it? Everyone knows it causes cancer. Some just don't think it will happen to them, or just don't care.

Given that the disease is mainly caused by a bug found in fish in fresh water ponds, it's understandable that Udon Thani has a higher incidence of it than most other places in the world.

Edited November 7, 2010 by whybother

[NanLaew]

Gotta die of something.

[asiawatcher]

Most of the treatable ailments can be sorted via education. Some graphic Video like the smoking TVC's where they take a cancerous lung and squeeze the ooze from it, same same for livers. Shock treatment is often the only way for Thai's. Logic and common sense is rare in these (or most) matters.

[mrdome]

Gotta die of something.

So let's just speed up the process?

[ronz28]

Discussed previously at

This is more current news confirming same Thailand liver cancer fact.

[katana]

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.

I think that should be nitrosamine...

[cloudhopper]

Discussed previously at

http://www.thaivisa....me/page__st__25

This is more current news confirming same Thailand liver cancer fact.

Another hub opportunity.

[housepainter]

I found it a usefularticle and not to try the fermented fish, which stinks anyway. I can't most of us ever eating raw fish.

The problem isn't cultural, it's pure ignorance. This is shown to be the case by the 'remedies' the Thai's accept. Furthermore, I can sympathise with the medical profession but not the ignoramus' that eat the raw fish.

It won't be solved any time soon but then it doesn't affect we farangs; those stupid, to be taken to the cleaners farangs.

But whose laughing now?

[Tokay]

Guys, 2 questions....

1) Is there a test anyone knows of to check for this parasite?

2) Can anyone write in Thai fermented fish and fermented fish sauce?

Thanks.

[geriatrickid]

The bill is between Bt40,000 and Bt50,000, often beyond the means of many sufferers."

Maybe this will impress on some people that keep insisting that the poor can access health care, that the poor cannot get the surgery nor the palliative care needed.

[craigt3365]

Wow shocking stats, A government campaign of awareness with a few clever commercials and banning uncooked fish sauce would save quite a few, but I don't expect that will occur.

Read the last 3 lines:

-----------------------------------------------------------------

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

-----------------------------------------------------------------

I cringe when I head to Issan and watch them eat raw beef and pork. I try to explain the problems, but they just eat it anyway. Won't let wifey and her mother eat it anymore....

That's the same as smoking isn't it? Everyone knows it causes cancer. Some just don't think it will happen to them, or just don't care.

Given that the disease is mainly caused by a bug found in fish in fresh water ponds, it's understandable that Udon Thani has a higher incidence of it than most other places in the world.

For sure. Same as smoking....same as drinking. The latter is my poison.

I mentioned this to wifey and she said health care workers come to her village fairly often talking about this. They have handouts, give lecturers, etc. She says everybody knows of the problem, they just do it anyway...

[jfk]

hi guys,

what about those smelly crabs they put in. do they carry this ?

many thanks,

jfk

[katana]

Guys, 2 questions....

1) Is there a test anyone knows of to check for this parasite?

2) Can anyone write in Thai fermented fish and fermented fish sauce?

Thanks.

Fermented fish (sauce) is ปลาร้า.

In Isan dialect it's ปลาแดก.

[Shurup]

Since we talk about Thai food here, how safe is to eat the Pappaya Sald (with crabs or whatever) bought from street when they make it right in front of you. I just love it even though my face, my mouth in in fire, I can't stop eating it until I'm done.

[Pi Sek]

Guys, 2 questions....

1) Is there a test anyone knows of to check for this parasite?

2) Can anyone write in Thai fermented fish and fermented fish sauce?

Thanks.

Fermented fish (sauce) is ปลาร้า.

In Isan dialect it's ปลาแดก.

I always thought they'd use a ล instead of a ร for "pla-lah". Thanks!

I suppose it doesn't matter - coi bo mak somtam pla-daek. Besides, very few somtam vendors I know make any difference between the L and the R.

I've got to learn how to spell!

[moetownblues]

Glad I don't eat fish