Thread: Liver fluke-induced cancer – an unending nightmare in Thailand

Liver fluke-induced infection is a major public health problem in Europe and South-East Asia, especially Thailand. It is a food borne infection that occurs in regions where uncooked cyprinoid fish is a staple of the diet. Due to poor sanitation, the feces of infected people is deposited in water resources, which in turn infect the fish, through snails that serve as intermediate hosts. This sets off a vicious unending cycle of infection, that results in Liver Cancer.

Approximately 10-25% of liver cancers are said to be a resultant of liver fluke infection. In the year 2004, 28000 people in Thailand succumbed to liver fluke-associated cholangiocarcinoma (CCA).

Hepatocellular Carcinoma (HCC), the other common form of liver cancer is more common worldwide but comparatively less common in Thailand. CCA is a major cause for alarm and the prognosis is poor. It has been observed that patients affected with severe CCA survive for typically 65 days post infection.

Opisthorchis viverrini, is the parasite that causes the highest number of CCA infections. While some heavily infected patients exhibit abdominal pain, a large number of patients go unnoticed owing to the lack of conclusive symptoms. Enlargement of the gall bladder is observed in infected patients, but this can be reversed by the elimination of parasites. Jaundice is the main clinical manifestation that results in the hospitalization of 60% of patients suffering from CCA.


O. viverrini: The Culprit

Pathological consequences of O. viverrini infection occur mainly in the liver, extra-hepatic bile ducts and gallbladder. Cholangiocarcinomas tend to grow slowly and to infiltrate the walls of the ducts, dissecting along tissue planes. Local extension occurs into the liver and regional lymph nodes. Life-threatening infection (cholangitis) may occur that requires immediate antibiotic intervention and aggressive biliary drainage.

Cholangiocarcinoma is a major cause of concern that has plagues the world, and Thailand, in particular for the last few decades. The only process of stopping the vicious cycle of infection involves mass treatment of infected individuals with anthelmintic therapy that causes the expulsion of these parasites. While this would serve as only a stop gap measure, sanitation and hygiene needs to be improved to curb cholangiocarcinoma in the long run.

Liver fluke-induced cancer ? an unending nightmare in Thailand | biotechin.asia

My MiL practically drools just smelling that fcuking shit. She's lost 2 family members to Bile Duct cancer in the past few years but still scoffs it.

Originally Posted by Pragmatic

My MiL practically drools just smelling that fcuking shit. She's lost 2 family members to Bile Duct cancer in the past few years but still scoffs it.

An Old Aussie mate of mine who has lived here for 20 years or so told me a long time ago that Pla Raa and Low Khow are two of the biggest killers in Issan , although Jan my wife does not drink she occasionally indulges in that evil looking and equally smelly shit (whilst I'm out of course ) you would think that they would be warned the medical profession about the dangers of consuming it , but hey TIT.

Originally Posted by piwanoi

you would think that they would be warned the medical profession about the dangers of consuming it , but hey TIT.

They have been. There are huge campaigns in that part of the country - going to villages, programs involving school kids etc. Screening and drug treatment regimes to kill the parasite. All to little avail.

I know some of my highly educated staff eat that stuff. When reminded of the possible consequences, they just shrug. Weird.

There was quite an interesting thread on this on the board a couple of years ago - which got a bit messy, so may well be gone - but the poster Hazz had some very, very interesting "contrarian views".

Originally Posted by nidhogg

Originally Posted by piwanoi

you would think that they would be warned the medical profession about the dangers of consuming it , but hey TIT.

They have been. There are huge campaigns in that part of the country - going to villages, programs involving school kids etc. Screening and drug treatment regimes to kill the parasite. All to little avail.

I know some of my highly educated staff eat that stuff. When reminded of the possible consequences, they just shrug. Weird.

There was quite an interesting thread on this on the board a couple of years ago - which got a bit messy, so may well be gone - but the poster Hazz had some very, very interesting "contrarian views".

When I finished my post I had a word with Jan and asked her had she been informed of the dangers and the consequences of consuming that foul smelling shite , she said no never ,any way I told her what the Thread said , she said that's it no more eating it , so its done one bit of good , Cheers Hans

Originally Posted by Hans Mann

It has been observed that patients affected with severe CCA survive for typically 65 days post infection.

I think this should read "post diagnosis" (of cancer). The infection takes years to develop into cancer.

Originally Posted by Hans Mann

In the year 2004, 28000 people in Thailand succumbed to liver fluke-associated cholangiocarcinoma (CCA).

Wow ! I didn't realize it was so many !

They do have awareness workshops in Thailand.

Deadly dish: the dinner that can give you cancer - BBC News

Originally Posted by Horatio Hornblower

They do have awareness workshops in Thailand.

Deadly dish: the dinner that can give you cancer - BBC News

Just spoke to the village headmans son about it who is home from Uni for New year who speaks good English , he said they may have info centres , but no body choose's to go , he also told me they have a yearly centre for giving mammography for detecting breast Cancer and in the 3 villages in our area only 9 went ,thankfully Jan was one of them .