Interview with Saman Chumtok

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 Interview with Saman Chumtok: Cholangiocarcinoma can be treated if found early

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Ms.Saman Chumtok, Don Chang villagers, who was found that she was sick as cholangiocarcioma (CCA) when being recruited as a subject in the research project “Application of biomarkers for screening of opisthorchiasis-related hepatobiliary diseases in the high risk area of cholangiocarcinoma in Khon Kaen Province” conducted by Prof.Puangrat Yongvanit, the principal investigator. After being diagnosed with serum markers and screened using ultrasonography, she was suspected to be a CCA. Saman was then investigated using a magnetic resonance imaging (MRI) for her liver and bile ducts at Khon Khen Hospital and she was diagnosed as a CCA. She was then transferred to Srinagarind Hospital for the treatment.

The team went to talk to Saman with helps by Ms. Jansuda Srimeungsook, the research assistant of Prof.Puangrat Yongvanit’s project. On that day, Saman in a nice look and dress was waiting for an interview.

How did you know you had a CCA?

There is a push on my tummy but it did not hurt. When the researchers from Khon Kaen University came to the village, they collected our urine and faeces for their project. After that, they brought us to investigate the disease using ultrasonography at Srinagarind Hospital.  Many of us came together and they found 6 people suspected for CCA. Only me was accepted the surgical treatment. Others refused. Two of us have already died.   Four of us are still alive but refuse to get surgical treatment. I feel so comfortable after surgery until now.

Were you scared or not when you knew that you were a patient with CCA? 

I was so scared. I slept with putting a hand on my forehead. However, I did not wait too long to see the doctor for the appointment. I lost my weight in several kilograms. I knew the results of the blood test and ultrasonography for the research project. I had to contact the Khon Kaen Hospital and they referred me to Srinagarind Hospital for further investigation and treatment.

I was so frightened at the beginning. I didn’t what doctors did. They took me to the operation room. When I became conscious, I only saw the doctor. I cried a lot. The doctor asked me why you cried. I said that when I woke up I did not see any relatives then I started crying. The doctor told me that I would be fine and getting better soon. Then I stopped crying. I thought I would have not woken up again.  I stayed in the hospital for 11 nights. My illness was getting better and better.

How did you feel after treatment?

I lived normally. My family took care of me to get healthy. I ate everything.

Will do you eat raw fishes anymore?

I will never eat them anymore. If I eat fermented fishes I will cook them well before eating. I always teach children not to eat raw fishes although they told me it is so delicious but I still insist to tell them not to eat. I face with CCA by myself so I am so scared of it. 

When I was young, I worked in the rice field. I ate only fish meal, especially spicy raw fish dish. Those fishes are mostly fresh water white scale fishes. Now I do not totally eat them.

How is your health at the moment? 

I have a better health but I cannot work as hard as before. After treatment, I have not taken any medicine. I have to check up every six months. My health has no problem. I gained weight a lot. Dr.Narong asked me to visit the CCA patients who are scared of surgery by telling them to be brave.

How long did you make a decision to accept the treatment?

When I decided to undergo surgery, the doctor advised me the way how to treat CCA and let me to decide whether you get treatment. I analyzed myself that if I got treatment, I would have a big chance to be alive. I then decided to undergo surgery. I made the right decision for my whole life.   

[Jansuda told us more about Saman’s feeling in her illness before surgery. Saman was very frightened of the surgery. Jansuda brought Saman to the hospital for chatting with CCA patients. She then felt relieved. The nurse at the Ward 3A talked to Saman and advised her to prepare herself for surgery and how to care after treatment. Saman felt more confident. After surgical resection, Saman recovered rapidly. She admitted in ICU ward only one night. She could walk on a second day.]


Are you very lucky that your CCA has been detected at the early stage?

Yes, I was very lucky at the day when the disease was detected.


What do you want to say for children?

 Tell them not to eat raw fishes, as I did.


What do you want to tell new CCA patients?

Check up your liver to screen the early CCA every year if you are in the risk group. It you are suspected to be CCA, please undergo surgery. Then you will be cured. 


Today, Saman’s health has no problem. She is healthy as old-age person can be. This is the case study for us to learn how to prevent CCA. We learn that patients with the early stage of CCA can be cured by undergoing surgical treatment and it can help patients to live longer than 5 years. We now know that CCA is a “silent disease” and people who have this disease have mostly low income. Most of patients who have the disease have no symptom. We are delighted that ultrasonography is a crucial tool to resolve the burden of early detection of CCA.