'made it happen at lightning speed': new metro vancouver surgical centre reduces waiting times for skin cancer surgery
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dr. iren kossintseva (in green scrubs), dr. noelle wong (in dark blue scrubs) and dr. angela burleigh (in purple scrubs) at the shellbridge family health clinic in richmond on saturday.
jason payne
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it’s a lucky day if dr. irén kossintseva has finished her surgeries by 7:30 p.m.
“sometimes our surgeries go until 3 a.m.,” said kossintseva, a skin cancer surgeon and clinical associate professor at ubc. “i drink my water at the microscope, and i go until it’s done.”
kossintseva is used to working almost around the clock to perform mohs surgery on patients with skin cancers on sensitive areas — such as the face, genitals and hands — that require immediate cosmetic reconstruction.
mohs surgery is a precise technique with a cure rate of over 99 per cent and is globally considered the gold standard. with 12- to 18-month waiting times in b.c., the yukon and the northwest territories, kossintseva and her team — who operate out of the dermatologic surgery centre at vancouver general hospital — could not get to patients fast enough.
“waiting more than a year for surgery is devastating,” said kossintseva.
all of that is about to change.
on oct. 28, a new facility operated by the seymour health clinic and vancouver coastal health will open six new procedure rooms, which will reduce waiting times by half and double capacity by delivering up to 3,000 additional surgeries annually.
the new seymour dermatology and mohs centre in richmond is the product of tenacity, determination and a team of three female surgeons — kossintseva, dr. angela burleigh and dr. noelle wong — who advocated change, and came up with a novel solution to make it happen.
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the problem wasn’t lack of talent. it was a shortage of facilities.
when she, burleigh and wong approached seymour health’s chief medical officer, dr. eric cadesky, in july 2025 about finding a solution, he was immediately on board.
shellbridge health clinic in richmond had several unused rooms. could they be retrofitted for the delicate surgery?
seymour health’s chief medical officer, dr. eric cadesky, when told of the new solution, was immediately on board.
doctors of b.c.
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“it was an overwhelming yes from the three of us,” said kossintseva.
“in a relatively short period of time we’ve been able to take a great idea, flesh it out, work on the details, and make sure it works,” said cadesky.
“we brought this to vancouver coastal health to obtain their support to build out these facilities,” said cadesky. “we will be able to take an additional 1,500 people off the waitlist every year.”
“they made it happen at lightning speed,” said kossintseva.
mohs micrographic surgery does not require a hospital stay but is performed in a clinic setting under local anesthesia. a surgeon and lab technician examine tissue samples in real time to ensure complete removal of the malignancy, while sparing as much healthy tissue as possible.
mohs is typically performed on skin cancers such as basal, squamous or early-stage melanomas. after the removal of the tumour, the patient undergoes cosmetic reconstruction of the area.
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the process is a science, and an art, said kossintseva.
one of dr. iren kossintseva’s sketches after removing a tumor to properly chase after the cancer roots. all patient and other identifiers have been removed.
dr. iren kossintseva
“a mohs surgeon never knows what they are going to get,” said kossintseva, who likens tumours to icebergs, with hidden dimensions under the surface.
“it’s not a symmetric iceberg,” said kossintseva. “cancer roots can be superficial or very deep, they can starfish, or extend for centimetres and you may not still capture it going the same radius all around.”
mohs surgeons remove the “clinically obvious” tumour tissue first, then leave the operating suite as their lab technician prepares the tissue for examination under a cryostat, a piece of equipment used to slice microscopically thin tissue samples.
kossintseva compares the cryostat to a microscopic prosciutto slicer. each horizontal slice is examined to determine the characteristics of the tumour and its spread. “it’s laborious. we spend hours at the microscope,” said kossintseva.
then kossintseva draws a map with pen and paper, returns to the patient, shows them the map and explains whether she needs to go deeper or wider, and how she will proceed.
the process repeats until the cancer is completely removed. even if it takes until 3 a.m.
the cosmetic reconstruction, done the same day, is just as important as the removal of the cancer.
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“there is an art to it,” said kossintseva. “there is no damage or defect that cannot be repaired.”
to work as efficiently as possible, each surgeon can have up to three patients at a time, moving from operating suite, to lab, to operating suite, never stopping for a moment.
dr. irén kossintseva at the shellbridge family health clinic in richmond.
jason payne
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in b.c., one in seven people will experience skin cancer. among solid-organ transplant patients, many of whom develop squamous cell carcinoma due to immunosuppression, that number is much higher.
“this new centre is a dream come true, and will help thousands and thousands of patients across b.c,” said wong, division head of dermatology at st. paul’s hospital.
“we know our public health care system is under tremendous strain,” said cadesky. “this is the utopia that most doctors have been asking for: to innovate and take our expertise to the health authorities and governments to improve patient care.”
what made it possible was a team of dedicated, motivated surgeons, and a creative approach to transforming underutilized space.
“not only are patients benefiting, it’s also economically responsible,” said cadesky.
capacity for mohs surgery will increase from 2,600 surgeries a year to 5,200.
and maybe, just maybe, kossintseva will get a little more sleep.
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