By Gary Rothenberg, DPM, CDCES, CWS, Director of Medical Affairs at Podimetrics

This post draws a comparison between diabetic foot ulcers (DFUs) and cancer, not to equate the two, but to better communicate the serious nature of DFUs. Many individuals are impacted by both conditions, and we approach this analogy with the deepest respect for patients, families, and care teams affected by cancer. We aim to foster awareness, drive earlier intervention, and improve outcomes in diabetes-related foot complications.

Reframing Diabetic Foot Ulcers

As a podiatrist, I’ve spent years helping patients navigate the complex and often overwhelming complications of diabetes. Among the most devastating is the diabetic foot ulcer (DFU). It’s a condition that’s both underrecognized and undertreated — despite its potential to be life-altering. Diabetic foot ulcers are the leading cause of lower extremity amputations in the U.S. In fact, every 3.5 minutes, someone loses a limb to diabetes — and most of these amputations are preventable.

In a recent presentation, I reviewed a concept that offers a powerful way to reframe how we think about DFUs: comparing them to cancer. While the analogy isn’t new, it remains a compelling tool for improving how we communicate risk, coordinate care, and support patients.

DFUs and Cancer: A Comparison Worth Making

At first glance, diabetes-related foot wounds and cancer may seem unrelated. But looking more closely, we find significant parallels — not to compare the conditions, but to help reframe how we think about DFUs:

• Serious Health Risks: Patients with lower-extremity complications from diabetes face five-year mortality rates that are comparable to — or even exceed — some forms of cancer. In fact, more than 85% of major diabetes-related amputations are preceded by a foot ulcer, and the five-year mortality rate following amputation is more than double the average for all reported cancers, which stands around 31%.

• Impact on Daily Life: Both conditions can limit a person’s ability to live independently and engage in the activities they enjoy.

• A Heavy Burden: DFUs, like cancer, can bring significant challenges — physical, emotional, and financial — for patients, families, and care teams.

• Complex Care Needs: Treatment for DFUs often involves multiple specialties, advanced therapies, and long recovery times — echoing the complexity of cancer care.

• Persistent and Recurring: Both conditions often require long-term management and carry a high risk of recurrence.

• Resource Demands: The direct healthcare costs of diabetic foot disease are substantial, approaching those of cancer care in many systems.

Changing the Narrative: The “Malignancy of the Foot”

This analogy is not about labels — it’s about perspective. It allows us to speak with greater clarity and urgency, especially with patients who may underestimate the seriousness of a foot ulcer.

• “DFU = Malignancy of the Foot”: This reframing emphasizes that DFUs are not just skin-deep wounds. Like a malignancy, they can progress silently, affect deeper structures, and require aggressive intervention.

• “Amputation = Mastectomy”: This isn’t a one-to-one comparison. Instead, it’s a way to express the profound emotional and physical impact of limb loss — a life-changing outcome that deserves greater empathy and preparation.

• “Cure” vs. “Suppression”: Cancer care often pursues remission through surgery, chemotherapy, and radiation. Similarly, DFU care might involve surgical resection (to remove infected or necrotic tissue) and long-term medical management (such as antibiotics or advanced wound care) to suppress ongoing threats.

• Healing as Remission: Rather than declaring a DFU “healed,” perhaps we should adopt the language of “remission”. This shift helps:
  • Communicate Risk: Patients understand the possibility — even probability — of recurrence.

  • Reinforce Monitoring: Emphasizes that regular follow-up becomes part of the long-term care plan and preventative management.

  • Promote Proactive Prevention: Encourages lifelong foot care to support ulcer-free, hospital-free, and activity-rich living.

Taking a Page from Oncology: The Case for a Limb Preservation Board

In oncology, tumor boards bring together specialists across disciplines to build cohesive treatment strategies. Could we apply this model to diabetic foot care?

A Limb Preservation Board — involving podiatrists, endocrinologists, vascular surgeons, infectious disease experts, and more — could collaborate on shared cases, identify risks earlier, and implement unified plans to prevent amputations. This team-based approach holds real potential to improve outcomes.

Advancing DFU Care: Inspired by Oncology’s Successes

The cancer care model has taught us the value of community, awareness, and system-wide coordination. DFU care can benefit from the same momentum:

• A Recognizable Symbol: Cancer has the ribbon — what will represent DFU awareness?

• Public Advocacy: High-profile voices have advanced cancer awareness. Who will be the champions for limb preservation?

• Informed Media: Coverage that educates and empowers the public can help shift perceptions, making preventive foot checks as normal as routine cancer screenings.

A Compassionate Analogy for Change

The cancer analogy isn’t about shock value — it’s about clarity. It gives us a framework to speak more honestly and effectively about the serious risks posed by diabetic foot ulcers, without diminishing the profound challenges of cancer. It invites us to learn from a field that has made remarkable progress in awareness, coordination, and patient-centered care.

Let’s do the same for DFUs. Let’s reduce preventable amputations, protect mobility, and preserve limbs. Let’s extend lives and empower people with diabetes to live fully — with fewer hospital stays, more independence, and a future focused not just on healing, but on thriving.

At Podimetrics, our mission is simple and urgent: to save limbs and save lives. This is how we get there.