Vietnam soldiers who ingested a parasite (trematode) during their tour appear to be at more risk for a deadly bile duct cancer called cholangiocarcinoma. This is a cancer that starts within the biliary system (liver, bile ducts and gallbladder) and easily spreads if gone unchecked.
These parasites, known as “liver flukes”, are endemic to Vietnam, China, Thailand, South Korea and much of Southeast Asia. Its believed 30-35 million people are infected with these liver flukes. They live in fish and, if not cooked properly, find a home in ones gastrointestinal system upon ingestion. Many liver fluke illnesses are asymptomatic and if early illness is detected, an antiparasite pill such as praziquantel, tribendimidine, or albendazole, could treat it. If not noticed, the fluke settles in and causes chronic inflammation that can cause the delicate biliary tissues to turn cancerous. The exact mechanism for the cancer is unknown.
The parasite not only is ingested by eating raw or undercooked fish, but unwashed vegetables could carry it as well. Blood and stool tests may be able to pick up the parasite and an ultrasound or CT scan could detect inflammation within the bile ducts.
We currently do not know how many Vietnam veterans are affected, but any symptoms of chronic indigestion, jaundice, bloating, gas, constipation, abdominal pain, hives, nausea, vomiting, fatigue and/or weight loss should be evaluated by a gastroenterologist.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician