How a Sinai Health orthopaedic surgeon is engineering a new approach to sarcoma.

Dr. Kim Tsoi’s love of orthopaedic surgery didn’t begin in a university lecture hall or during a med school residency. In fact, medicine was the furthest thing from Dr. Tsoi’s mind until she found herself thousands of kilometres from home, in South America.

Long before “Dr.” was added to her title, Tsoi took a year off from her chemical engineering studies to teach English in Paraguay. Her students were a group of orthopaedic surgeons who, to her surprise, offered to show her how surgery was done. Jumping at the chance to feed her ever-curious mind, Dr. Tsoi learned enough Spanish to pass the required anatomy course to get inside the operating room.

Dr. Tsoi quips, “I taught them English and they taught me surgery. From the first day, I was in love with orthopaedic surgery, and there was no question that’s what I was going to do.”

By the time Dr. Tsoi returned to Canada, she had completely re-routed her academic career and enrolled in medical school, but never forgot the fundamentals of engineering, now the compass for how she cares for sarcoma patients today.

“More than anything, engineering teaches you how to problem solve, and it’s a good framework to provide the best possible care to patients,” says Dr. Tsoi. “Orthopaedic oncology really is the perfect surgical specialty for an engineer: identifying the problem, analyzing different avenues and coming up with a patient-specific solution. Every patient, tumour and situation are completely unique.”

For a doctor who revels in a challenge, there’s no better place in the world than Sinai Health’s Christopher Sharp Cancer Centre. The Centre is home to the largest multi-disciplinary sarcoma program in Canada and is one of the top three sarcoma research centres in the world, which is why 85 per cent of patients come from outside the city to receive its world-renowned care and expertise.

“What I love about Sinai Health is the people, it’s such a wonderful multidisciplinary team,” says Dr. Tsoi. “From the nurses to my partners, the oncologists, radiologists and the pathologists, we have such different backgrounds but are all working towards similar goals.”

As a surgeon-investigator, Dr. Tsoi splits her time between the operating room and the research lab, where she hones her training in biomedical engineering and nanotechnology to better understand sarcoma - the same cancer Terry Fox had.

“I still think surgery and radiation will be the backbone of treating sarcoma, but I believe we’re on the cusp of breakthroughs,” says Dr. Tsoi. “The next big step is using cutting-edge technology to better understand what drives these tumours and the infrastructure at Sinai Health will help us offer these therapies. We are really one of the few places in the world to get this done.”

Dr. Tsoi’s important research is being recognized by the federal government. One of the latest recipients of a Canada Research Chair, Dr. Tsoi’s work will be supported for the next five years. For now, Dr. Tsoi is focused on the task at hand: helping patients whose treatments have been sidelined by the COVID-19 pandemic.

“The most devastating part of it is the delay in diagnosis, we’ve never seen anything like this,” laments Dr. Tsoi. “I’ve lost count of the amount of young people whose disease was so advanced, we’ve had to tell them the surgery we could have done months ago will now be more difficult, or not possible at all.”

Despite the obstacles brought on by the pandemic, Dr. Tsoi is more committed than ever to guiding her patients through what can be a frightening journey.

“We often meet our patients at the worst part of their lives. They’re often young and otherwise completely healthy. It’s such a devastating diagnosis,” says Dr. Tsoi. “To be part of their journey the difficult surgeries, chemotherapy and radiation, and the difficult recovery, and to follow them on the other side and see them go back to their lives, it really is a privilege to do this job.”