One Delicious Dinner Can Give You Cancer

One dish in north-east Thailand, a raw fish delicacy, stokes liver cancer in the residents of the area, even as doctors are trying to educate the people about the illness, according to bbc.

This is the Isaan plateau of north-eastern Thailand, which is "poor, dry, and far from the sea". About one-third of Thais live here, most of them ethnic Lao. Its spicy dishes, made from whatever ingredients are locally available, are popular.

At some spots where there are rivers or lakes, the Thais use smaller fish to make small, pungent dishes called koi plaa. While the fish are cut into small, fine pieces, they are then mixed with local herbs, lime juice and live red ants, and served raw to the consumers.

The locals adore their food, especially "the traditional varieties of fermented fish that one aficionado describes as tasting like heaven but smelling like hell," according to nytimes. They are not able to fight cancer due to the "deeply ingrained love of the sour and smoky-tasting fermented dishes that generations of villagers have relished."

However, while the dish is in much demand, it is dangerous. Many people in the north-east part of the country tend to develop "abnormally high levels of liver cancer". Most men contract the disease, comprising more than half of the cancer cases, against a global average of less than 10%.

The infection of liver cancer is caused by liver flukes, parasites found in raw fish. In the last decade, some have been advising that cooking koi plaa would kill the flukes before they are eaten.

The flukes in the fish get into the liver of the humans, and grow and increase, laying eggs. These eggs are excreted and get back into the water where the fish are residing. They are eaten by snails and then by fish---restarting the deadly cycle, according to iflscience.

Patients who are hosting the liver fluke eggs tend to excrete them into the water. Dr. Banchob Sripa at the Tropical Disease Research Laboratory in Khon Kaen University is trying to change the eating habits of the residents.

"We have been studying this link in our labs for over 30 years", he said. "We found that the liver fluke can make a chemical that stimulates a host immune response - inflammation - and after many years, this becomes chronic inflammation, which then becomes cancer."

The scientists found that in some areas, about 80% of people were inflected by the fluke. Children as young as four years old might get the eggs, but the cancer develops only when they reach 50 years. After that they do not survive.

The university hospital gets 2,000 patients annually with a form of liver cancer called cholangiocarcinoma. Of these, just 200 can be treated with surgery, when tumours are cut out from the liver. Others are helped with palliative care, to ease their discomfort by draining bile ducts till they die. The only way to escape the liver flukes completely is through prevention.

Hence, Dr. Banchob and his team conduct a community-based health education programme in villages near the wetland, Lawa Lake, where liver fluke infection rates are highest.

They are explaining the dangers of raw fish to the next generation. The most effective techniques for the area is to teach them about its harmful properties. The community leaders do the talking, and a lot of lively north-eastern music and humour is ingested into the lessons. Many of the songs spread the information to the locals.

Infections have plummeted sharply to just 10% in some areas.