Sushi in Asia – No thanks!

A close friend of mine was recently diagnosed with cholangiocarcinoma, or cancer of the bile ducts. He became ill very quickly and doctors thought it was a case of Hepatitis-B which is often food-borne, but usually resolves on its own without treatment. But he kept getting yellower and yellower, and sicker by the day, as the bile built up in his system. Advanced tests, scans, and exploratory surgery revealed inoperable cancer of the bile ducts (inoperable because one tumor is so large and right on the artery), as well as several other tumors on both lobes of the liver. “Go home and prepare for the end” the doctor said, “you have between six months and a year”.

On my intense urging, my friend agreed to contact an M.D. associate of mine who brokers a “second opinion” service that refers your entire file to Harvard for review and assessment as to what else can possibly be done. The doctors there were intrigued by the fact that all his tumor biopsies were negative for cancer, but the tumors looked and behaved as if they were cancerous.

Canadian doctors agreed to re-open his case and now suspect that he has a benign form of the disease caused by, get this…..eating sushi in Asia (my friend had been to Asia some months previously)! It turns out that a liver fluke parasite found in fish in Asia (but not in North America) has the ability to cause tumors to grow in the biliary system. Here is a fascinating abstract from the American Journal of Gastroenterology, dating back more than 20 years, that talks about how many Asian immigrants to North America actually have the fluke resident in their livers.

“In the Far East infection with the liver flukes Clonorchis sinensis and Opisthorchis viverrini is the most frequently documented cause of cholangiocarcinoma. Liver fluke infection in the United States remains a health problem for more than 500,000 Southeast Asian refugees who have immigrated to this country since 1975. Recent surveys have revealed that up to 26% of Asian immigrants have an active liver fluke infection. However, the common clinical manifestations of this condition, as well as the possibility of developing such long-term sequelae as cholangiocarcinoma, remain unknown to many physicians providing care for this population. This report describes a clinically unsuspected C. sinensis infection associated with cholangiocarcinoma in an elderly Chinese immigrant, and emphasizes the importance of early diagnosis and treatment of all liver fluke infections in the prevention of bile duct neoplasms in high risk populations”.

Anyway…..I know that I won’t be touching sushi next time I visit Asia! I am unfortunately addicted to the stuff here and will continue eating it since there are very few cases of any infections (of any kind) reported in North America.

References:

Am J Gastroenterol. 1986 Jan;81(1):76-9.// <![CDATA[//