Prioritization for Mohs Surgery
With limited resources in a public system, there are only a few centres that perform Mohs surgery in Canada. Many provinces are currently without a Mohs surgeon making access to this service difficult. To access care, your referring physician must provide a biopsy report confirming the existence of a tumor and sufficient information about you and the precise history and location of your tumor for a proper triage assessment. A referral form is available to physicians. Cases are triaged based on the severity of cancer, the typical rate of cancer growth, and the risk of metastatic spread. Location of the cancer may play a lesser role but is still important. As patients are typically not seen in consult prior to their surgery date, a factor related to the high demand for this service, the precision and comprehensiveness of the information provided regarding your cancer is critical to this triage process. Urgent requests for removal of basal cell cancers, which are typically slow-growing non-metastatic cancers, cannot typically be accommodated given the known natural history of this tumor. In most cases this delay has little effect on the size of the cancer, the complexity of the surgery, and final patient outcome.
Note to Patients and Referring Doctors:
In an effort to try to address the long waiting list for MOHS surgery. Dr. Cowan will often make attempts to have a locum surgeon cover his surgical practice during his absence for vacations. The staff will typically notify you and your referring doctor that you will not be care for by Dr. Cowan, should your surgery be scheduled during one of Dr. Cowan's vacations. If you do not wish to see a locum surgeon, please notify both your initial referring doctor and Dr. Cowan's office staff.