A THAI delicacy made of raw fish has been found to cause deadly liver cancer.
Koi pla – as the dish is known – is native to the Isaan province north-east Thailand, which for years has been rocked by sky-high rates of bile duct cancer.
It wasn't until recently that scientists have linked these cases to the cheap plate of raw fish ground with spices and lime enjoyed by locals.
The carcinogenic dish is so deadly that it's believed to be killing up to 20,000 people in Thailand per year.
It's not a particular ingredient in the dish per se that causes cancer – rather it's the parasitic flatworms, called liver flukes, that sometimes live in the raw fish used.
The parasites are native to fresh water fish in the Mekong region.
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As a result, Isaan is said to have the highest reported instance of aggressive cholangiocarcinoma – bile duct cancer – in the world due to heavy consumption of the raw fish meal.
A doctor from the region, Narong Khuntikeo, has for years fought to warn locals on the dangers of the silent killer dish after losing both his parents to cholangiocarcinoma.
"It’s a very big health burden around here," the liver surgeon told Agence France-Presse.
“But nobody knows about this because they die quietly, like leaves falling from a tree.”
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Narong put together a team of scientists, doctors and anthropologists, who drove ultrasound machines and urine testing kits around the Isaan region, testing villagers for the parasite.
Up to 80 per cent of the inhabitants of some communities were found to have ingested the parasite.
And at a testing site visited by AFP, a third of villagers had abnormal liver symptoms and four were suspected to have cancer.
What is cholangiocarcinoma?
Chalangiocarcinoma is cancer that's found anywhere in the bile ducts – these are small tubes small tubes that drain digestive fluid from the liver and gall bladder.
Symptoms can be hard to spot.
According to the NHS, they include:
- The whites of your eyes turning yellow or your skin turning yellow, which may be less obvious on brown or black skin (jaundice)
- Itchy skin
- Darker pee and paler poo than usual
- Loss of appetite or losing weight without trying to
- Feeling generally unwell
- Feeling tired or having no energy
- A high temperature, or you feel hot or shivery
Other symptoms can affect your tummy, such as:
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- Feeling or being sick
- Pain in your tummy
You should get an urgent GP appointment if you experience those symptoms.
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