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One Bite Of Thai Cuisine Linked To Liver Cancer Risk

Discover how one bite of Thai cuisine linked to liver cancer risk can impact public health. Explore the dangers lurking in a traditional dish, koi pla, and its global implications.

Author:Black Crystal
Reviewer:Maxwell Canvas
Sep 13, 202324K Shares364K Views
It's hard to resist the allure of Thai cuisine, with its rich flavors and comforting textures. These dishes have become a staple in households and restaurants worldwide, from Pad Thai to Tom Yum soup to the much-loved Thai green chicken curry. However, when it comes to one bite of Thai cuisine linked to liver cancer risk, a less-known dish from the Thai province of Khon Kaen, named koi pla, is causing a health crisis that's hard to ignore.
A single bite of this delicacy could potentially lead to liver cancer. According to estimates, the dish is responsible for a staggering 20,000 deaths in Thailand each year. While koi pla isn't likely to be found on your local Thai takeaway menu, it is extremely popular, particularly in one of Thailand's poorest provinces, Isaan.

International Impact And Awareness

Although koi pla is primarily a regional concern, it has broader implications for international public health. With the globalization of cuisines and increasing travel to Southeast Asia, the risk extends beyond the Isaan region. Some reports have even indicated isolated cases among tourists and Thai expatriates. This elevates the issue from a local crisis to a globalcautionary tale.

A Dish That's Killing Thousands

Koi pla is a dish that consists of minced raw fish combined with herbs, spices, and lemon juice. Eaten by millions in Thailand, this is the dish when it comes to one bite of Thai cuisine linked to liver cancer risk. It has been linked to an alarmingly high rate of liver cancer, specifically cholangiocarcinoma or bile duct cancer, especially in the Isaan region.
Koi Pla and Liver Cancer Findings
Koi Pla and Liver Cancer Findings

Understanding The Symptoms And Diagnosis

Cholangiocarcinoma is a rare but increasing type of cancer that originates in the bile duct system, encompassing the gallbladder, bile ducts, and certain liver cells. This form of cancer tends to become more prevalent as people age and is associated with various risk factors such as primary sclerosing cholangitis, chronic ulcerative colitis, bile duct cysts, liver cirrhosis, Hepatitis B or C, diabetes, obesity,andgenetic predispositions.
Moreover, one of the key triggers for bile duct cancer in Southeast Asia is infection with parasitic worms, also known as liver flukes. These parasites, specifically Opisthorchis verrini and Clonorchis sinensis, mature within the human bile duct system, causing inflammation and scarring that can eventually lead to cancer. Eating raw or undercooked fish containing these parasites is the primary route of infection.
Symptoms of cholangiocarcinoma can often be subtle, appearing only in the advanced stages of the disease.
Symptoms of cholangiocarcinoma include:
  • Jaundice
  • Abdominal pain
  • Darkened urine
  • Light-colored stool
  • Fever
  • Itching
  • Nausea
  • Vomiting
  • Sudden weight loss
Diagnosis generally involves a comprehensive medical history, a physical examination, and a range of tests, including blood tests and medical imaging like X-rays, CT scans, and MRIs.
Dr. Narong Khuntikeo further added, "It’s a very big health burden around here. But nobody knows about this because they die quietly, like leaves falling from a tree."
Dubbed the 'silent killer,' liver cancer has one of the lowest rates of survival if left untreated.
Khuntikeo has been working for the past four years with a team of scientists, doctors, and anthropologists testing Isaan villagers for the parasite. Using ultrasoundmachines and urine testing kits, it was found that around 80% of people in some communities had ingested the lethal parasite.

The Battle Against A Cultural Staple

Dr. Narong Khuntikeo's efforts highlight the challenge of changing eating habits deeply rooted in local traditions. "It's a sensitive issue because koi pla is an integral part of our culture," he notes. "However, the risks are too great to ignore, and I'm fighting against this dish to save lives."

Tackling The Stigma And Educational Barriers

Changing long-standing cultural practices and beliefs is never easy. There is often resistance from community members who see such changes as an attack on their heritage and way of life. For example, older generations may dismiss the risks, and their perspectives could hinder community-wide acceptance of the necessary behavioral changes.
Khuntikeo concedes that changing the mindset of the older generation is challenging. "They’ll say: 'Oh well, there are many ways to die.' But I cannot accept this answer," he states emphatically. Health officials have also developed a school curriculum to teach children about the risks of consuming raw foods like koi pla, but lovers of the dish argue that cooking the fish—which effectively kills the parasite—ruins the taste of the meal.
Eradicating the parasites is another difficult task, as they are naturally occurring in the freshwater of the Mekong region. Thus, the focus has shifted to educating the population about the risks associated with consuming raw fish.
A woman preparing Koi Pla
A woman preparing Koi Pla
"Public awareness is the first step in combating this deadly dish. We need to make people understand that a single bite could potentially cost them their life," warns Dr. Khuntikeo.
The health crisis surrounding koi pla puts a grim shadow over the otherwise vibrant and much-celebrated Thai cuisine. While experts and activists work to curb the consumption of this dish, the stark statistics remain a troubling testament to the urgency of the issue.
As the fightagainst this deadly delicacy continues, the world watches and hopes that the toll it takes on Thai communities can be halted.
Until then, as Dr. Khuntikeo puts it:
We must be vigilant in our efforts to educate and protect our people from the very real dangers posed by koi pla.- Dr. Narong Khuntikeo
This dark tale serves as a cautionary reminder of a world where international cuisines are celebrated and enjoyed far beyond their countries of origin. Sometimes, what's considered a delicacy in one culture could pose severe risks that should not be ignored.


What Preventive Measures Are Being Taken For Liver Cancer In Thailand?

Various preventive measures are in place to curb the incidence of liver cancer. The government and health organizations have launched awareness campaigns, and some regions have introduced food safety regulations to ensure fish served in dishes like koi pla are free of parasitic worms.

Is Koi Pla A Common Dish In Other Parts Of Thailand?

Koi pla is primarily a regional dish popular in the Isaan area. However, with internal migration and cultural exchange, it is gradually making its way into other regions, raising health concerns beyond its place of origin.

How Is Cholangiocarcinoma Treated?

Treatment of cholangiocarcinoma often involves a multidisciplinary approach including surgery, chemotherapy, and radiation therapy. Early diagnosis is key, which makes awareness and regular check-ups crucial.

What Is The Global Impact Of This Health Crisis?

While the crisis is most acute in the Isaan region, the globalization of Thai cuisine poses a risk of spreading this health issue. Some isolated cases have been reported among tourists and expatriates, elevating it from a regional to a global concern.

Are There Any Cultural Beliefs That Make Eradication Efforts Difficult?

Changing long-standing traditions is challenging. Many older community members dismiss the risks, making it hard to gain community-wide acceptance for behavioral changes. These deep-rooted cultural beliefs are a major roadblock in the fight against liver cancer in the region.

How Does This Issue Affect The Reputation Of Thai Cuisine Internationally?

The health crisis puts a grim shadow over Thai cuisine, which is otherwise celebrated for its rich flavors and diversity. The risks associated with koi pla have led to increased scrutiny and could potentially affect the global perception of Thai food safety.

What Are The Symptoms Of Parasitic Worm Infection?

Symptoms of infection by liver flukes, which are a primary cause of cholangiocarcinoma, can include abdominal pain, jaundice, and unexplained weight loss. However, symptoms are often subtle and appear only in advanced stages.

Is There Any School Curriculum To Educate Children On This?

Yes, health officials have developed a school curriculum to educate children about the risks of consuming raw or undercooked fish, aiming to change eating habits from a young age.

What Is Being Done To Eradicate The Parasitic Worms From The Environment?

Efforts to eradicate the parasitic worms are complex due to their natural occurrence in the freshwater systems of the region. Currently, the focus has shifted to public awareness and food safety measures rather than complete eradication of the parasites.

How Does One Get Diagnosed For Cholangiocarcinoma?

Diagnosis often involves a comprehensive medical history, a physical examination, and a series of tests including blood tests, CT scans, and MRIs to confirm the presence of the cancer.


In a world where international cuisines are celebrated and savored, the case of koi pla serves as a stark reminder that not all that tantalizes the taste buds is good for our health. The risks are too grave to ignore, and public awareness is crucial in mitigating them. The incident where one bite of Thai cuisine linked to liver cancer risk encapsulates the severity and immediacy of the health crisis facing not just the Isaan region but potentially anyone who indulges in this dish.
As we relish the rich flavors and comforting textures of Thai cuisine, let's also be vigilant about the very real dangers that some traditional dishes can pose. This somber tale is not just a cautionary story but a call to action for communities, health organizations, and governments to work collaboratively in raising awareness and implementing preventive measures to save lives.
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Black Crystal

Black Crystal

Black Crystal is a captivating writer who finds inspiration in the quiet corners of the street and the mysterious depths beneath bridges. With a penchant for the night, she crafts enchanting tales that explore the uncharted realms of the human experience. Embracing the darkness as her muse, Black Crystal's evocative prose and haunting imagery transport readers into a world where secrets whisper and dreams take shape. Her writing defies categorization, inviting readers to uncover the magic hidden within the shadows and embrace the enigmatic beauty of her nocturnal narratives. Step into her realm, where the written word dances with ethereal grace, and immerse yourself in the captivating stories she weaves.
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