Are Mild Wound And Diabetic Foot Infections Like Mild Cancers?

David G. Armstrong DPM MD PhD

I was listening to a superb talk recently by Otis Brawley, MD, for our TEDMED at University of Arizona simulcast. Dr. Brawley, the Chief Medical Officer for the American Cancer Society, was speaking about the dramatic overtreatment of prostate and some breast cancers when they were in their early stages. Late in the 18-minute talk, he recounted an anecdote that I had not heard. It had to do with Donald Gleason, MD, PhD, and a meeting he had more than 50 years ago. Dr. Gleason is best known for the eponymous "Gleason Score" for prostate cancer.

Anyway, the story goes that Dr. Gleason was attending a task force meeting with his peers. He was uncomfortable with using the term "cancer" for early-stage prostate disease. He favored “adenosis.” He was outvoted.

I cannot help but see the parallels 50 years on when we speak of wound infections. Are we overdiagnosing mild wound and diabetic foot infections? Certainly, these need to be contained but perhaps we can do so without calling them infection.

Words and language and taxonomy are important. I think they also change over time. To look forward, let us look back to our forefathers lest we risk suffering adenosis atrophy.

This blog has been adapted with permission from a previous blog that originally appeared at www.diabeticfootonline.blogspot.com .

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