DEAR DR. ROACH: I have been diagnosed with chronic lymphocytic leukemia at stage I, and I am experiencing swelling in my lymph nodes under my arms and in my neck. I was wondering what are the best natural treatment options, such as green tea extract, and what are the latest clinical trials or research studies that would be applicable. Also, what are the nutritional needs to fight CLL? — N.H.

ANSWER: Chronic lymphocytic leukemia is a disease of the bone marrow, an indolent (slow-growing) type of cancer. It is called CLL when the cancer cells are mostly in the blood, and small lymphocytic lymphoma (SLL) when it is primarily in the lymph nodes. These are just different manifestations of the same disease. However, if the disease is mostly in the lymph nodes, then radiation treatment usually is used, even in asymptomatic early disease. In stage I CLL, the condition typically is watched for progression.

For cancer in general, I think that using natural treatments, including a diet designed to help support the body’s own defense mechanisms, is a good idea when combined with standard treatments that your oncologist recommends. I cannot agree with dietary or supplement treatment instead of treatments that have been proven to work, and I urge you to discuss your desire to consider complementary and alternative treatments with your oncologist. In stage I CLL, in absence of recommendations for treatment, it is reasonable to consider complementary approaches.

In the case of green tea extract, a well-done study showed promise in early-stage CLL. This study used polyphenon E at a dose of 400 mg to 2,000 mg orally twice a day. Unfortunately, this compound is not available commercially and is not well-absorbed by mouth. There are supplements available commercially, but, as always, I must warn that these generally are not tested independently.

I also found some preliminary evidence about curcumin (turmeric) as a possible treatment for CLL. However, the research is more preliminary than it is with polyphenon E. It is possible that the two may be used together. Neither of these is a cure for CLL, but may slow progression.

Most authorities recommend that people with cancer consume a diet of mostly vegetables and fruits, whole grains if you eat grains, fish, nuts and legumes but avoid red meat and processed foods. That’s pretty good advice for most people.

DEAR DR. ROACH: I am a 77-year-old male. I have really been shedding the hair on my arms and legs. Is this normal for a man of my age? I have been taking hydrocodone and simvastatin, along with the usual vitamin supplements. Could the medications or supplements that I am taking have anything to do with my hair loss? Could it be my diet, or just old age? — R.C.

ANSWER: Hair loss on the arms and legs is less common than on the scalp. Hormonal changes (especially thyroid and testosterone) and medications can be the culprit. A myriad of skin diseases can do it, but these usually have visible skin changes associated. Chronic swelling (edema) of the extremities might be the cause.

Simvastatin has rarely been associated with hair loss. However, when I see hair loss on the lower extremities, I worry about peripheral artery disease, which is very common and underdiagnosed. Being on simvastatin suggests that you have had high cholesterol, which is a risk factor for PAD. Having hair loss on both arms and legs, however, makes me more concerned about a systemic cause.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from

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