LIVER CANCER - A TRULY DEADLY DISEASE
An insight into a growing global killer
- Published: 30/07/2009 at 12:00 AM
- Newspaper section: Mylife
Thailand has the highest number of patients with bile duct cancers in the world. The busy lifestyle of the modern era combined with an unhealthy diet can contribute to the development of many severe diseases including cancers. And liver cancer is killing more and more people worldwide. It's therefore important to understand how serious liver cancer is and how we can help ward off the disease.
Volunteers take part in activities at a training session of ‘‘Gin Sook Saeb Lai - Tan Phai Mareng Tub’’.
THE INCIDENCE OF LIVER CANCER IN THAILAND
The liver is one of the most vital organs in the body. From circulation, to digestion and neutralisation of harmful toxins and wastes, this organ of the body functions to keep us healthy and sustain our life. However, because the liver consists of various types of cells, several kinds of tumour can develop.
There are many kinds of cancers that start in the liver. Two types are common in Thailand. They are hepatocellular carcinoma and cholangiocarcinoma. The first one is generally caused by the Hepatitis B virus, Hepatitis C virus and a carcinogen called alfatoxin. The latter is rooted from a parasitic infection of the bile duct and a carcinogen called nitrosamine.
CHOLANGIOCARCINOMA OR BILE DUCT CANCERS
About six million Thais, mostly in the northeast, are reported to have opisthorchiasis (being infected with fluke worms), one of the major causes of Cholangiocarcinoma. This comes from food or water-borne parasite worms such as opisthorchis viverrini - including fluke worms - which reside in the skin of freshwater fish mostly found in northeastern Thailand.
Dr Thairavud Khuhaprema
Another cause is nitrosamine, a carcinogen found in such food as fermented fish, pickled pork, salted fish and sausages.
The National Cancer Institute reported that the prevalence of bile duct cancers in the northeast are 80 male cases and 40 female cases per 100,000 of the population. In Western countries, there's only one case of bile duct cancer per 100,000 of the population.
Over the years, the Ministry of Public Health has run a campaign against opisthorchiasis through various activities. Field trips have been arranged to test for liver fluke worm eggs and the distribution of praziquantel, a drug used against the worms. The findings show that the prevalence of opistorchiasis has gradually declined. However, it seems the occurrence of liver cancer has not decreased.
Dr Thairavud Khuhaprema, Chairman of National Cancer Institute Foundation, said that to help reduce the number of patients with liver cancer - particularly bile duct cancer - the foundation has worked hand in hand with Bayer Thai Co, Ltd in a pilot campaign entitled "Gin Sook Saeb Lai - Tan Phai Mareng Tub" (Let's Eat Cooked Food to Prevent Liver Cancer).
Dr Wanchai Sattayawuthipong
"This project targets the younger generation. Under the campaign, we have arranged training to educate volunteers on how to prevent bile duct cancer, which is one of the major public health problems in Thailand. We have also provided them with many useful teaching aids and techniques, hoping they will pass on the knowledge they learn from the training to other villagers and urge them to quit eating under-cooked food. To help the villagers better absorb the information, we hired a "Mor-Lum" (Isan style music) band to compose a song in order to promote this campaign, the doctor added.
THE HABIT OF A LIFETIME
One of the main reasons the Ministry of Public Health's former campaign against opisthorchiasis wasn't successful was due to the villagers' habit of consuming half-cooked food and mistaken beliefs. It's Isan people's belief that adding lime juice or the eggs of red ants cooks the food. They also believe that if they drink rice whisky after eating under-cooked food it will prevent opisthorchiasis because the alcohol in the whisky can kill liver fluke worms in the body.
Dr Bancha Tanchaovalit
"It is very difficult to break the habit of consuming under-cooked food. Most Isan people argue that because they eat the same
half-cooked food as cancer victims and haven't developed a tumour, it can't be the food at fault. The cancer must have another cause. I suppose they at the National Cancer Institute have to keep researching the issue until they can give them irrefutable proof," said Dr Wanchai Sattayawuthipong, deputy director of the Medical Service Department, the Ministry of Public Health.
HOW IS BILE DUCT CANCER DIAGNOSED?
According to Dr Bancha Tanchaovalit of Udon Thani Regional Cancer Centre, most cases of bile duct cancer are not detected until the symptoms develop.
This is because the bile duct is located deep inside the body. Without effective screening tests, it's not easy for a doctor to detect early tumours. Some of the basic symptoms of bile duct cancers include:
Jaundice, a condition where a patients' skin and the whites of the eyes become yellow. It occurs when the liver cannot get rid of bile, and bilirubin in bile goes back up into the blood stream.
Loss of appetite and weight loss. Patients with bile duct cancers may not feel hungry and begin to lose weight.
Abdominal pain. Full blown bile duct cancers may lead to severe abdominal pain, particularly below the ribs on the right side.
Itching. When excess bilirubin in the blood reaches the skin, patients can have an itch.
A low fever. Some patients with bile duct cancer may develop fevers.
CAN BILE DUCT CANCERS BE DETECTED EARLY?
"Only a small number of bile duct cancer cases are found early before they spread too far. But if patients go to see a doctor when they first notice the symptoms, the cancer might be diagnosed at an early stage when it is most treatable," the surgical expert answered.
HOW IS BILE DUCT CANCER TREATED?
Dr Bancha said not all patients with bile duct cancers are curable. Unfortunately, out of 100 patients, there are only 1-15 cases who can be potentially treated. When possible, surgery is the most effective treatment as it promises a good chance for a cure.
There are two surgery options for bile duct cancer treatment - potentially curative surgery and palliative surgery. The first will be done if tests indicate a good chance for the surgeon to remove the entire tumour. If the tumour has spread too far, palliative surgery will then be undertaken to ease pain or prevent complications which may occur later. In fact, palliative surgery is not used to cure a tumour, but it can help relieve symptoms and prolong the patients' life.
Relate Search: Bile duct cancer, Gin Sook Saeb Lai, Tan Phai Mareng Tub
About the author
- Writer: By SUKHUMAPORN LAIYOK
