Sylvia Karydakis Dutton, 53, the first woman to manage a bank branch in Washington, died of cancer August 15 in Tijuana, Mexico, where she had gone for treatment. The Washington Post September 1976

BY THE TIME Sylvia Dutton was aware that something serious was wrong, it was probably too late to do anything about it. It was the autumn of 1975, and "she started to be tired" her husband remembers. "She had a little pain and they couldn't locate it." Doctors told her it was diverticulitis, and treated that. But finally, by the dawn of the new year, the pain could be ignored no longer and she went back for further tests. She had two large tumors in her ovaries. "When the doctor reported to me after surgery," her husband remembers, "he said the cancer had spread to the lymph system."

The Rev. Rolland Dutton and I spoke in his home on a quiet street on a quiet block in the town of Lighthouse Point, Florida, not far from Miami. A very lonely man, Dutton's eyes filled with tears as he spoke of his late wife, "the most wonderful person I ever met. She was always outgoing, optimistic." The bungalow the couple shared seemed, three months after her death, to be a shrine to Sylvia and Jesus.

We spoke after church, two church services to be precise, which Dutton conducts weekly at a nearby retirement village - one service for the ambulatory and one for the people in wheel chairs. His shoes, socks and tie off, the retired minister, whose Cadillac bears a bumper sticker reading "I Found It," sat surrounded by an array of photos and mementos of Sylvia. He said they were set up for my benefit, but it seemed as likely that they were there to comfort him. A large picture of Jesus dominated the living room from above the piano. The house was still full of her possessions: their shared bedroom, as it was, dominated by a great dark four-poster bed with a white chenille spread: on the television, a gray stuffed elephant and stuffed dog, gifts to Sylvia during her illness. Dutton stumbled over his words, choking up as he opened drawers to reveal her jewelry collection, her clothes. Everything was "we." "I" had not yet sunk in except in the loneliness of mourning.

Sylvia Dutton's prognosis was hopeless, but she and her husband never gave up hope. That is why she died down the street from the Tijuana bullring, rather than in their white stucco bungalow or in a Miami hospital. She went to Mexico because friends of friends in Florida told her she would find a cure there for the cancer that had consumed her ovaries and spread to her lymph system. She checked into Hospital Del Mar, for years the best-known of the Laetrile clinics, because she had put her faith in those stories; because she and her husband believed that Laetrile was her last chance to stay alive.

At the time, Laetrile was being dispensed to as many as 20,000 American patients a year at Hospital Del Mar. There is no neat way to type those who have gone there except to say that they are, or think they are, suffering from cancer, and they are desperate. They span the social, educational and sociological spectrum and have only their suffering in common.

Some of the patients have lived to become advocates of the drug, their "case histories" fueling the controversy that has surrounded its legalization in eleven states - and its denunciation by U. S. Surgeon General Julius Richmond. Some survivors present their testimonials of miraculous "cures" to anyone who will listen. They tell of finding life where they had been promised only death. They do not present scientific evidence, but those looking for a cure are as impressed by the testimonials of the survivors as they would be by a myriad of formal tests. And that is why Sylvia Dutton's story is important: she did not survive. In that sense, hers is the typical story of a Laetrile user. Her testimonial comes from the grave, an account of unwarranted hope and faith misplaced, and it is like the story the majority of Laetrile users would tell if they were alive today.

Sylvia Karydakis, the daughter of Greek immigrants, was born in the mill town at Lowell, Massachusetts, where her father was a tailor. While she was still a child her family moved to Washington, and she attended District schools, graduating from Roosevelt High Schook, where she completed the business course. She made enough of an impression there for the principal to write a letter of congratullations to her fifteen years later when she was named the first woman officer of the then Second National Bank of Washington.

She moved quickly though the ranks, and was named assistant cashier in January 1955, assistant vice president five years after that, assistant vice president and secretary in 1962. In November 1966 Sylvia Dutton became the "first woman to manage a bank branch in Washington," taking over the First National Bank of Washington's MacArthur Boulevard branch.

"She liked people and she just went out of her way to please them," remembered her brother-in-law, Donald Hollingsworth, a senior vice president of the same bank. "Of course the customers of the bank were just so very fond of her." Her advancement was not due merely to competence or intelligence, but to her personality, her ability to deal with people and reassure them with her own optimism. It was her "fine personality," explains Hollingsworth, that explains her success at a time when many professional women were necessarily hard-bitten.

"When she started it was all men. But as the years went by more and more women came into the bank and they were capable and worked hard. So when the opportunity came for a management position, it was natural that Sylvia should get it."

Sylvia Karydakis and Rolland Dutton crossed paths late in both their lives. The pastor of Washington's Temple Baptist Church, Dutton was one of those residents of the area who recognized Sylvia's "special warmth." "We had an account for the church there and then I had a personal account there. This is just a sidelight," he said with a laugh, "I used to go down there to do some business and I wouldn't bother her, in fact she hardly knew I existed. But I would watch her deal with her clients. Some of them would come in for a loan and she'd have to turn them down, but she would always send them away with a smile, feeling happy. So I said, 'my goodness it would be great to live with somebody like that.' So that's really how it started."

When the minister and the banker first began courting, some of her friends and relatives were leery of the difference in their ages. "I think a good many of them pictured her having to take care of this old man for years to come," said Dutton, "but it just didn't work out that way. You just can't predict these things. And she had always been such a very healthy person. She lived right, she didn't smoke or drink. She played volleyball and basketball and tennis. She was a good bowler. For ten years there at the bank she never missed a day. I never knew her to be sick, to even have a cold."

Marriage to Rolland Dutton - then 68 years old and ready for retirement - brought with it the most radical alteration of life style possible for the 48-year-old Sylvia Karydakis, who had not only lived an independent adult life, but had held a position of authority and responsibility.

After their marriage the Duttons moved from Washington to rural, southern New Jersey, where Dutton was director of a school for juvenile first offenders. Sylvia was the director's wife. That was it. In a June 1971 mimeographed letter to friends, she described her new life at Ranch Hope:

"I am enjoying the great change from business woman to housewife and, although I miss the family and friends, it is most pleasant to live in a small town. Presently, we are in an apartment located on a small lake. . . . Rolland is working very hard and enjoying the challenge of his new duties - never a dull moment, with boys running away, smoking on the sly, etc." The letter continued on in that vein, listing Rolland's activities and accomplishments and, by omission, Sylvia's lack of activities. But the last paragraph gave some indication that, while her banking career was gone, it was not forgotten:

"Most distressing to me was the news of the increase of holdups of financial institutions in Washington and particularly of the attempt at MacArthur Boulevard, shortly after I left, and the one at National Permenent Savings & Loan in the building adjacent to my old office, where a policeman was shot to death. As both were unsuccessful, perhaps fewer attempts will be made in the future. I am grateful none of the members of the staff was injured."

"She loved banking," said her sister, Sophia Hollingsworth. "It was in her blood. After they moved to Florida she tried on a number of occasions to get back into the banking field. However, in Florida women aren't recognized as executives; they like women in secretarial positions but not as executives. She found that kind of a hassle. She didn't have a real job after she got to Florida.Not that she regretted it," Mrs. Hollingsworth added. "It's just that it was something she wanted to do. After all, she married Dr. Dutton and there wasn't any problem or anything. She was just bored being a housewife. It was obvious."

Slyvia had always been healthy, remembered her sister, "she'd never been ill, other than a cold or something like that. But she had been ailing since October [1975] and they hadn't found anything specific. She was up here just after Christmas [of that year] and she didn't know that she had cancer. She just felt terrible. She spent almost a week with me and she did nothing but sleep. She was just worn out all the time. She said she had diverticulitis, but I said, 'No,' because everything she did for that malady wasn't helping her. So finally in January she found she had a more serious problem than she thought.

"I went down for ten days after she got out of the hospital," her sister continued, "and she said she was going to lick it. The two of them were very optimistic. "Whether he knew more than she knew, I don't know. Even up to the very end she thought this Laetrile was going to lick it. My other sister went down two weeks before they went to Mexico and at that time she still thought she was going to lick it."

After her disease was diagnosed as cancer, the specialist treating Sylvia had proposed radiation therapy and she agreed to it. "She had fifty-six treatments in fourteen weeks," her widower said, "there were very few side effects and not much pain. But then she developed shingles and had blisters all down the side of her body." According to Dutton, the shingles interrupted the radiation for six weeks during May and June of last year. It wasn't a long delay, but it may have been a fatal one.

The cancer was too far gone to respond to further radiation. As a last resort, the physicians suggested chemotherapy: the administration of powerful, toxic chemicals designed to kill the cancer cells. "They tried to recommend it," Dutton said, with some bitterness in his voice, "but we decided against it. They said it might causes nausea and vomiting, bone marrow depression, loss of hair, anemia and possible loss of muscle control," he said, listing all the drawbacks of present chemotherapies. Dutton failed, however, to include the one hoped-for effect of the chemotherapy: it might have postponed his wife's dying.

"But we'd been hearing a great deal from friends and others about the situation down in Mexico," he said. "We knew people at church who had been down to Mexico and tried it. There are at least a dozen people in this area who were told they were going to be dead from cancer who used Laetrile and now they're out playing tennis."

First developed in the early 1950s by biochemist Ernest Krebs - whose name means cancer in German - Laetrile is a chemical compound synthesized from certain natural products, including apricot pits and almonds, which are rich in cyanide. According to Krebs's theory, the Laetrile releases its cyanide in the presence of cancer cells, poisoning them but not effecting the surrounding normal cells. The proponents of Laetrile claim cancer is, in effect, a vitamin deficiency disease. Laetrile, they claim, is a vitamin, B-17, which not only stops the spread of cancer but also acts as a prophylactic, preventing it from developing.

There are, of course, several basic problems with these theories. In the first place, Laetrile is not considered a vitamin by anyone other than Laetrile proponents.It's not a basic chemical needed to maintain life. The vitamin theory has been pushed with more and more fervor as an attempt to get around Food and Drug Administration regulation and suppression of Laetrile. Laetrile, say its proponents, is not a drug, it is a vitamin. Therefore it should be sold over the counter in drugstores without FDA interference.Secondly, there is a major question as to whether the substance being given cancer patients is Krebs' Laetrile. About two years ago a group of British scientists tested the "Laetrile" being dispersed at Mexican clinics and found it to be amygdalin, the chemical produced by Krebs in the first step of his two-step process for the manufacture of Laetrile. Though amygdalin is chemically similar to Laetrile, it lacks the most important similarity: it does not release cyanide in the same manner as Laetrile is supposed to. So even if Laetrile does work by poisoning cancer cells, it may be that whatever it is the 20,000 patients a year who go to Mexico are receiving isn't poisoning their cancer cells - though indeed it may be poisoning them.

One of the stock arguments of the pro-Laetrile forces is that even if Laetrile does no good, it does no harm, and should therefore be made available to cancer patients who are, after all, dying, and deserve whatever peace of mind the chemical can bring them. But as Dr. Philip Schein, chief of medical oncology at Georgetown University's Lombardi Cancer Research Center points out, "there's no body of data that specifically proves Laetrile safe. It's like the lack of data on its efficacy, we're faced only with testimonials of individuals receiving this material. We don't even know what's being given," said Schein, echoing the British report published in New Scientist magazine. "We don't know if it's anything close to the product it's supposed to be. The FDA has rather rigid guidelines for [drugs] that each batch must be tested for purity and chemical content. There's no question that Laetrile contains cyanide and potentially in large doses there's the danger of cyanide poisoning. All claims of safety must be disregarded until there's factual data presented."

The only safety data presented thus far was submitted in July to the Journal of the American Medical Association. Schein and three colleagues at Georgetown reported on two cases of patients who suffered serious drug reactions to Laetrile they had received from sources outside Georgetown. One of the patients was a woman who entered the hospital with a fever of 102 and rash on her body. Within twenty-four hours after coming off Laetrile the symptoms disappeared. When the woman left the hospital against physician's advice and resumed taking Laetrile the symptoms reappeared. The second patient was a man who experienced paralysis of the muscles of the eyes and eyelids. He too was taken off Laetrile and his symptoms also disappeared. In both cases the symptoms were such that a physician treating the patient with Laetrile might well have diagnosed them as being part and pancel of the disease, rather than being drug reactions.

"Many of the patients who received this material have been terminal and died," Schein continued. "Whether or not their death was contributed to by Laetrile has not been determined, and that has not been driven home."

But the glimmer of hope was too much for the Duttons to resist. So on July 21, 1976, Rolland and Sylvia flew to San Diego, then went on to Tijuana and Hospital Del Mar. "They said it was a good idea to get down there early," he said. The Duttons were pleasantly surprised by the appearance of the clinic and the friendliness and efficiency of its personnel, including founder dr. Ernesto Contranas. "It was quite attractive," recalled Dutton. "It's a white stucco, fifty-bed hospital. It's full all the time. We were fortunate to get in. I simply called his [Contranas] secretary. I had the contact."

When Dutton checked his wife in, "they just said, 'We'll do the best we can.' Every day we saw people go home, feeling fine, people who'd gotten there earlier." What Dutton didn't know, and what has not been properly documented, is how many of those people actually had cancer, and how many had had surgery, chemotherapy or radiation before going to Mexico. How many, in other words, were cured, or given remissions, with conventional therapy, remissions for which they credited Laetrile.

There were also those who died, and continue to die every day, at Hospital Del Mar. Sylvia was in a double room and "in both cases she was in with somebody who died. First her roommate [her age] and then a little girl." Sylvia Dutton entered the hospital on July 23, 1976. She was there twenty-two days, including the day she died.

Months afterward Rolland Dutton still believed in the cure that wasn't. "We just got there too late," he told me. The idea of having gotten there "too late" is the standard explanation given by Laetrile educates to explain the deaths of patients treated with Leatrile. There are no reliable numbers to attach to these deaths, just as there are no good numbers to attach to the "successes." In fact, very little is documented about Laetrile except repeated failure to show an efficacy when tested in animal tumor systems. The latest such failure came from the laboratories of the prestige-laden Sloan-Kettering Memorial Institution, in New York, where officials recently announced that a series of tests of the chemical had produced no beneficial results.

Some respected medical authorities and institutions, including the National Cancer Institute, are beginning to suggest that even though Laetrile has proved useless in animal tests - and some degree of success in such tests would be a normal precursor of human testing - trials with human cancer patients should be considered in order to lay the Laetrile myth to rest, along with such earlier quack cures as Krebiozen, once and for all.

Such suggestions are anathems to the Food and Drug Administration, whose officials argue that to allow testing and production of Laetrile without applying normal efficacy and safety standards would not be making an exception, it would be setting a horrible precedent. But such suggestions raise a far more important question: Do patients, particularly terminally ill patients, have a right to what one scholar has termed "life, liberty and the pursuit of quackery?" Should a patient be allowed to take whatever he or she wants, including Laetrile, as long as it bears proper labeling clearly stating that the substance is not a cure for anything? In this age of informed consent and patients' rights it is tempting to answer yes to both questions.

"If a person wants and needs a certain thing he ought to be able to get it," said Rolland Dutton. "If some people think it does good, and most of them agree it does no harm, I don't know why in the world they don't let people have it. I have found very few people who have benefited from radiation," said Dutton. "Don't you think there are cases where X ray has actually caused cancer?" The question was a genuine one, for Rolland Dutton is a genuinely perplexed man. "Our doctors recommended the operation which we went through, and apparently it didn't do any good - her doctor practically said so. Then they recommended radiation; and there's no sign that that did any good - I think she was worse off when she got through. So what do you do? There are so many arguments against this chemotherapy, and we know so many people who have suffered from it. It really puts you on the spot."

All during the time we were talking Dutton was continually passing me pro-Laetrile literature, much of it published by right-wing organizations who have adopted Laetrile as a political issue, a fight for "Freedom of Choice" as opposed to the medical dictates of Big Brother. "Now here's this doctor Kelly, who's quoted quite a bit, and you can see what he says," said Dutton as he handed me a copy of The Healthview Newsletter, in which, "In an exclusive interview, cancer researcher Dr. William Donald Kelly tells why he believes: There is no doubt in my mind that you can prevent cancer. Moreover, if cancer has already occurred, in the majority of cases you can stop it and destroy it." Kelly's theories include the use of "vitamin B-17, nature's defense against cancer" - Laetrile. Dr. William Donald Kelly, it should be noted, is a dentist, and not what would normally be termed a cancer researcher.

Rolland Dutton was sitting in his easy chair in his living room, surrounded by photographs of his wife. "She was always full of hope," he said, "she thought the Lord was going to heal her . . . But she was losing weight terribly." The five-foot six-inch woman weighed about 130 pounds when she was healthy. "She was about 85 when we got down there and below 80 when she died." His voice was beginning to break and there appeared to be tears in his eyes. "She had a marvelous attitude all the way through," he said. "She didn't blame the doctors or anybody."

"There is one thing, you see, which is even more important than getting well, and that is doing the will of God," Dutton said in the memorial he delivered for his wife a week after her death. "Last Saturday night, just a week ago - though it seems like a year - after Sylvia and I had read and talked about the 23rd Psalm, the 27th the 46th, the 90th, the 100th and many other precious verses and promises, she offered her own fervent prayer, much more for others than herself. Then on Sunday afternoon she was carried by the angels through the gates of heaven."

A long way from the Tijuana bullring.