Peer-Reviewed Indian Journal of Surgical Oncology Meets Challenges, Succeeds in Developing Country

A Conversation With K.S. Gopinath, MD

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Launching a new cancer journal is a risky and arduous endeavor, especially for a specialty publication in resource-challenged countries in the developing world. To succeed, a specialty journal must publish articles from established clinical researchers that quickly garner funding and captivate its intended audience, which is no easy task. The ASCO Post recently spoke with K.S. Gopinath, MD, Editor-in-Chief of the Indian Journal of Surgical Oncology, which first went to press in 2009. Dr. Gopinath sheds light on his journal’s early challenges, among other things, and its value in the Indian oncology market.

Official Publication of Indian Association of Surgical Oncology

Please give our readers a brief overview of the Indian Journal of Surgical Oncology.

The idea of the journal as an official publication of the Indian Association of Surgical Oncology was conceived in 2008 by then President Dr. Sanjay Sharma. Shortly after this, Dr. Sajeev Misra, the journal’s Secretary, was nominated to take over this responsibility. After the initial workup, the journal was published and released in 2009 by the incoming president Dr. M. Vijay Kumar. So far, we have published 28 issues.

The Indian Journal of Surgical Oncology is a quarterly, peer-reviewed, multidisciplinary journal that accepts articles on all specialized areas of oncology that engage surgeons in the treatment and management of cancer. The journal aims to serve as a medium of publication for original scientific work from India, as well as from around the world. We publish original articles and review articles; other specialty articles of importance and interest dealing with basic and clinical research will be considered for publication.

The Indian Journal of Surgical Oncology is published electronically and in print. The journal will include Cross Reference Linking; alert services; and Online First options, a feature by which articles are published online before they appear in print. The publisher, Springer, will also implement an online author submission system.

Motivating Oncologists to Present Original Research

What is the main obstacle you face with the journal moving forward?

The most significant challenge for the future is to motivate oncologists in this part of the world to present their original research and outcomes results as well as look into the emerging concept of precision medicine in oncology. To that end, we want to develop an adequate database platform for guideline developments and outcome results of Indian oncologic problems, which will further our goal of achieving Indian solutions for Indian cancers.

Editorial Excellence

What positive signs do you see in your journal moving forward in a difficult market?

Largely due to our insistence on editorial excellence, this journal has motivated undergraduate and postgraduate medical students, surgical residents, and other oncology professionals to showcase their innovation and insight in oncology. Despite the drawbacks involved in a developing country, we are seeing a promising increase in the number of articles submitted to the journal. We have been accredited by SCOPUS (an abstract and citation database of peer-reviewed literature), PubMed Central Index, Shannon-Weaver index, and Google Scholar.

Specializing in Head/Neck and Breast Cancers

Please tell our readers a bit about your background.

I was born in a rural town called Davangere in the province of Karnataka. I went to a primary convent school and then attended the JJM Medical College. I completed my higher studies in general surgery at the King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College in Mumbai and my surgical oncology training was at Tata Memorial Hospital in Mumbai. I obtained my FRCS (Honorary) from the Royal College of Surgeons in Edinburgh.

I joined the Kidwai Memorial Institute of Oncology in Bangalore, India, as a surgical oncologist until I founded the Bangalore Institute of Oncology in 1989, where I am to this day. Along with my administrative duties, I am a researcher specializing in the surgical treatment of head and neck and breast cancers.

India’s Cancer Care System

Please give our readers a brief overview of the challenges of practicing in the Indian cancer care system.

Although the growing understanding of cancer genomics and biology has opened new vistas in the management of cancers, India’s cancer care infrastructure is challenged by economic disparities and the lack of cancer services in rural areas of the country. The National Cancer Registry Programme (NCRP annual report 2014) has published epidemiologic data on the incidence of cancer and changing trends between population-based cancer registries and hospital-based cancer registries, looking at urban metropolitan areas and rural areas of India.

Although the growing understanding of cancer genomics and biology has opened new vistas in the management of cancers, India’s cancer care infrastructure is challenged by economic disparities and the lack of cancer services in rural areas of the country.
— K.S. Gopinath, MD

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In urban areas, the incidence of breast cancer is emerging as a predominant source of morbidity and mortality. Lack of widespread mammography screening programs is partly responsible for this disturbing trend. And compared with the West, a larger portion of breast cancers in India occurs in younger women.

The introduction of prevention strategies would have a great impact on cancer incidence and mortality. For instance, tobacco-related cancers account for 35% to 40% of all cancers in India. Also, cervical cancer, which is highly preventable and treatable if caught at an early stage, is the leading cancer killer of Indian women. Lack of countrywide Papanicolaou testing and human papillomavirus vaccination programs is a contributing factor to this unnecessary suffering and death.

Moreover, there is no single symptom to indicate that a person has cancer. Although the disease is one, it behaves differently in different parts of the body. Probably, this is one of the reasons many people present with advanced disease. Aside from that, most people tend to overlook their health issues, mostly because of their socioeconomic status.

Significant Challenges

In India, a large problem is the shortage of trained personnel to tackle the volume of increasing cancer patients. Even though in recent years the number of oncology seats in medical schools has increased, the total work force to deal with the cancer burden is dismally low.

Another major problem in the management of cancer patients in India is the rural-urban divide. There is an abundance of clinical material available to create a clinical research database, which could generate outcome results and quality care. However, there is a dire lack of financial support for research activities.

Patients tend to present clinically with more locally advanced disease due to a lack of screening programs. The Indian Council of Medical Research is now coming out with various guidelines to formulate uniform treatment methodology across the country, keeping in mind Indian solutions to Indian problems. Despite these significant challenges, I am optimistic about the future of oncology services in India. ■

Disclosure: Dr. Gopinath reported no potential conflicts of interest.