Abstract

To the Editor.— Alcohol and various forms of tobacco have been implicated as potent carcinogens.1,21,2 A case in point is that of a 53-year-old man with an 18month history of progressive dysphonia and dysphagia, accompanied by weight loss and easy fatigability. He had had no significant prior medical problems. He was one of eight children, only two of whom survived infancy. At the age of 7 years he was committed by his parents to an industrial school for boys, primarily for disciplinary reasons. He was a superb athlete. He soon rose to stardom, amazing fans with his sporting skills and amusing them with his endless drinking and tireless escapades. Significant health risk factors included the heavy use of chewing tobacco and alcohol for nearly 45 of his 53 years, along with smoking approximately 30 cigars daily for about 30 years. On initial medical evaluation 18 months prior to

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