Thai doctors battle cancer-causing raw fish dish in country’s northeast
The pungent and cheap meal, koi pla, served in rural Thailand can cause lethal liver cancer; up to 20,000 people a year are dying. A surgeon who saw it kill his own parents is testing villagers and urging them to change their diet
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 – it was their lunch.
Like millions of people from across the rural northeast of Thailand, 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 which kills up to 20,000 people in Thailand annually. Most hail from the northeast; a large, poor region known as Isaan that has dined on koi pla for generations and now has the highest reported instance of the Cholangiocarcinoma (CCA) – 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.
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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 Organisation.