Questions About Cancer? 1-800-4-CANCER

Aromatherapy and Essential Oils (PDQ®)

Health Professional Version
Last Modified: 01/11/2012

Human/Clinical Studies

Current Clinical Trials

No studies in the published peer-reviewed literature discuss aromatherapy as a treatment for people with cancer. The studies discussed below, most of which were conducted in patients with cancer, primarily focus on other health-related conditions and on quality of life measures such as stress and anxiety levels.

Among the fewest articles published on the subject are clinical trials involving aromatherapy. A major review published in 2000 [1] focused on six studies investigating treatment or prevention of anxiety with aromatherapy massage. Although the studies suggested that aromatherapy massage had a mild transient anxiolytic effect, the authors concluded that the research done at that time was not sufficiently rigorous or consistent to prove the effectiveness of aromatherapy in treating anxiety. This review excluded trials related to other effects of aromatherapy (such as pain control) and did not include any studies looking at the effects of odors that were not specifically labeled as aromatherapy.

Several of the studies included in the Cochrane Database of Systematic Reviews are discussed in more detail. A randomized controlled pilot study examined the effects of adjunctive aromatherapy massage on mood, quality of life, and physical symptoms in patients with cancer.[2] Forty-six patients were randomly assigned to conventional day care alone or day care plus weekly aromatherapy massage using a standardized blend of oils for 4 weeks. Patients self-rated their mood, quality of life, and the intensity of the two symptoms that were the most concerning to them at the beginning of the study and at weekly intervals thereafter. Of the 46 patients, only 11 of 23 (48%) in the aromatherapy group and 18 of 23 (78%) in the control group completed all of the 4 weeks. Patient-reported mood, symptoms, and quality of life improved in both groups, and there was no statistically significant difference between the two groups in any of these measures.

Another randomized controlled trial examined the effects of aromatherapy massage and massage alone on 42 patients with advanced cancer over a 4-week period.[3] Patients were randomly assigned to receive weekly massages with or without aromatherapy; the treatment group (aromatherapy group) received massages with lavender essential oil (Lavandula angustifolia Miller [synonyms: Lavandula spicata L.; Lavandula vera DC.]) and an inert carrier oil, and the control group (massage group) received either an inert carrier oil alone or no intervention. The authors reported no significant long-term benefits of aromatherapy or massage in pain control, quality of life, or anxiety, but sleep scores (as measured by the Verran and Snyder-Halpern sleep scale) improved significantly in both groups. The authors also reported statistically significant reductions in depression scores (as measured by the Hospital Anxiety and Depression Scale [HADS]) in the massage-only group.

A placebo-controlled, double-blind, randomized trial conducted in Australia investigated the effects of inhalation aromatherapy on anxiety during radiation therapy.[4] A total of 313 patients receiving radiation therapy were randomly assigned to one of three groups: carrier oil with fractionated oils, carrier oil only, or pure essential oils of lavender, bergamot (Citrus aurantium L. ssp. bergamia [Risso] Wright & Arn. [Rutaceae]; [synonym: Citrus bergamia Risso]), and cedarwood (Cedrus atlantica [Endl.] Manetti ex Carriere [Pinaceae]). All three groups received the oils by inhalation during their radiation therapy. The authors reported no significant differences in depression (as measured by HADS) or psychological effects (as measured by the Somatic and Psychological Health Report) between the groups. The group that received only the carrier oil showed a statistically significant decrease in anxiety (as measured by HADS) compared with the other two groups.

Another randomized controlled trial investigated the effects of massage or aromatherapy massage in 103 cancer patients who were randomly assigned to receive massage using a carrier oil (massage group) or massage using a carrier oil plus the Roman chamomile essential oil (Chamaemelum nobile [L.] All. [synonym: Anthemis nobilis L.]) (aromatherapy massage group).[5] Two weeks after the massage, the authors found a statistically significant reduction in anxiety in the aromatherapy massage group (as measured by the State-Trait Anxiety Inventory) and an improvement in symptoms (as measured by the Rotterdam Symptom Checklist [RSCL]; the subscales with improved scores were psychological, quality of life, severe physical, and severe psychological). The authors reported that the massage-only group showed improvement on four RSCL subscales; however, these improvements did not reach statistical significance.

In a placebo-controlled, double-blind, randomized trial of bergamot inhalation aromatherapy compared with a pleasant smelling shampoo that did not contain essential oils, administered around the time of stem cell infusion in 37 children and adolescents undergoing stem cell transplant, aromatherapy was not found to be beneficial in reducing nausea, anxiety, or pain. As administered in this study, bergamot inhalation aromatherapy may have contributed to persistent anxiety following the infusion of stem cells. Although no more effective than placebo, parents receiving aromatherapy showed a significant decrease in their transitory anxiety during the period between the completion of their child’s infusion and 1 hour following infusion. Nausea and pain subsided over the course of the intervention for all children, though nausea remained significantly greater in patients receiving aromatherapy. These findings suggest that the diffusion of bergamot essential oil may not provide suitable anxiolytic and antiemetic effects among children and adolescents undergoing stem cell transplantation. The double blinding of the trial may explain the results, as single-blinded or nonblinded trials in general supported the aromatherapy intervention.[6]

A similar study evaluated the efficacy of an aromatherapy intervention for reduction of symptom intensity of nausea, retching, and/or coughing among adult patients receiving stem cells preserved in dimethyl sulfoxide. The study found that an intervention of tasting or sniffing sliced oranges was more effective at reducing symptom intensity than an orange essential oil inhalation aromatherapy.[7]

A study whose primary objective was evaluating an aromatherapy service following changes made after an initial pilot at a U.K. cancer center also reported on the experiences of patients referred to the service.[8] Of 89 patients originally referred, 58 completed six aromatherapy sessions. The authors reported significant improvements in anxiety and depression (as measured by HADS) at the completion of the six sessions, as compared with before the six sessions. A small study examined the physical and psychological effects of aromatherapy massage in eight patients with primary malignant brain tumors attending their first follow-up appointment after radiation therapy.[9] The author reported no psychological benefit in these patients from aromatherapy massage (as measured by HADS) but reported a statistically significant reduction in blood pressure, pulse, and respiratory rate.

Antibiotic -resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin -resistant enterococcus, are an increasing problem worldwide, causing intractable wound infections. Compounded phytochemicals, such as lemongrass, eucalyptus, melaleuca, clove, thyme with butylated hydroxyl toluene, triclosan (0.3%), and 95 undenatured ethanol (69.7%) are being investigated against MRSA in vitro . No clinical trials have been performed.[10]

Two topical MRSA eradication regimens were compared in hospital patients. A standard treatment, which included mupirocin 2% nasal ointment, chlorhexidine gluconate 4% soap, and silver sulfadiazine 1% cream was given versus a tea tree oil regimen, which included tea tree 10% cream and tea tree 5% body wash. Both were administered for 5 days. One hundred fourteen patients received the standard treatment, and 56 (49%) were cleared of MRSA carriage. One hundred ten patients received the tea tree oil regimen, and 46 (41%) were cleared of MRSA carriage. In a small group of patients, the tea tree oil regimen was associated with a higher clearance rate of MRSA carriage in the axilla, groin, and wound sites, but the difference versus standard treatment was not significant.[11]

Current Clinical Trials

Check NCI’s list of cancer clinical trials for cancer CAM clinical trials on aromatherapy and essential oils 1 that are actively enrolling patients.

General information about clinical trials is also available from the NCI Web site 2.

References

  1. Cooke B, Ernst E: Aromatherapy: a systematic review. Br J Gen Pract 50 (455): 493-6, 2000.  [PUBMED Abstract]

  2. Wilcock A, Manderson C, Weller R, et al.: Does aromatherapy massage benefit patients with cancer attending a specialist palliative care day centre? Palliat Med 18 (4): 287-90, 2004.  [PUBMED Abstract]

  3. Soden K, Vincent K, Craske S, et al.: A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med 18 (2): 87-92, 2004.  [PUBMED Abstract]

  4. Graham PH, Browne L, Cox H, et al.: Inhalation aromatherapy during radiotherapy: results of a placebo-controlled double-blind randomized trial. J Clin Oncol 21 (12): 2372-6, 2003.  [PUBMED Abstract]

  5. Wilkinson S, Aldridge J, Salmon I, et al.: An evaluation of aromatherapy massage in palliative care. Palliat Med 13 (5): 409-17, 1999.  [PUBMED Abstract]

  6. Ndao DH, Ladas EJ, Cheng B, et al.: Inhalation aromatherapy in children and adolescents undergoing stem cell infusion: results of a placebo-controlled double-blind trial. Psychooncology : , 2010.  [PUBMED Abstract]

  7. Potter P, Eisenberg S, Cain KC, et al.: Orange interventions for symptoms associated with dimethyl sulfoxide during stem cell reinfusions: a feasibility study. Cancer Nurs 34 (5): 361-8, 2011 Sep-Oct.  [PUBMED Abstract]

  8. Kite SM, Maher EJ, Anderson K, et al.: Development of an aromatherapy service at a Cancer Centre. Palliat Med 12 (3): 171-80, 1998.  [PUBMED Abstract]

  9. Hadfield N: The role of aromatherapy massage in reducing anxiety in patients with malignant brain tumours. Int J Palliat Nurs 7 (6): 279-85, 2001.  [PUBMED Abstract]

  10. Sherry E, Boeck H, Warnke PH: Percutaneous treatment of chronic MRSA osteomyelitis with a novel plant-derived antiseptic. BMC Surg 1: 1, 2001.  [PUBMED Abstract]

  11. Dryden MS, Dailly S, Crouch M: A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization. J Hosp Infect 56 (4): 283-6, 2004.  [PUBMED Abstract]





Glossary Terms

adjunctive therapy (A-junk-tiv THAYR-uh-pee)
Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. Also called adjunct therapy.
antibiotic (AN-tee-by-AH-tik)
A drug used to treat infections caused by bacteria and other microorganisms.
anxiety (ang-ZY-eh-tee)
Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.
anxiolytic (ANG-zee-oh-LIH-tik)
A drug used to treat symptoms of anxiety, such as feelings of fear, dread, uneasiness, and muscle tightness, that may occur as a reaction to stress. Most anxiolytics block the action of certain chemicals in the nervous system. Also called antianxiety agent and anxiolytic agent.
aromatherapy (uh-ROH-muh-THAYR-uh-pee)
A type of complementary and alternative medicine that uses plant oils that give off strong pleasant aromas (smells) to promote relaxation, a sense of well-being, and healing.
aromatherapy massage (uh-ROH-muh-THAYR-uh-pee muh-SAZH)
A type of complementary and alternative medicine that uses rubbing and kneading of the skin with plant oils that give off strong, pleasant aromas (smells) to promote relaxation, a sense of well-being, and healing.
axilla (ak-SIH-luh)
The underarm or armpit.
bacteria (bak-TEER-ee-uh)
A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.
bergamot (BER-guh-mot)
A type of orange tree grown in Italy. The essential oil from the peel of this orange is used in perfume, to get rid of insects, and to flavor tea. Bergamot oil is also used in aromatherapy for depression, anxiety, and poor digestion. The scientific name for the bergamot orange tree is Citrus bergamia.
blood pressure (blud PREH-sher)
The force of circulating blood on the walls of the arteries. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80).
brain tumor (brayn TOO-mer)
The growth of abnormal cells in the tissues of the brain. Brain tumors can be benign (not cancer) or malignant (cancer).
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
carrier oil (KAYR-ee-er oyl)
An oil with little or no scent that is used to dilute or “carry” essential oils (scented liquid taken from plants).
cedarwood (SEE-der-WOOD)
A type of evergreen tree with hard fragrant wood that is a member of the cypress family. The oil from the wood is used in soaps, shampoos, bath salts, perfumes, aromatherapy, and to keep insects away. The scientific name is Juniperus virginiana. Also called Eastern red cedar and red cedar.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
control group (kun-TROLE groop)
In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works.
dimethyl sulfoxide (dy-MEH-thul sul-FOK-side)
A colorless liquid that readily dissolves many chemicals and penetrates animal and plant tissues. It is used in human medicine, veterinary medicine, and pharmaceuticals.
double-blinded (DUH-bul BLINE-ded)
A clinical trial in which the medical staff, the patient, and the people who analyze the results do not know the specific type of treatment the patient receives until after the clinical trial is over.
eucalyptus (YOO-kuh-LIP-tus)
A type of evergreen tree that is a member of the myrtle family. Oil from the leaves is used in very small amounts in mouthwash and in medicines and candy used to treat and soothe sore throats and coughs. It has also been used in some cultures to treat many other medical problems. The scientific name is Eucalyptus globulus.
follow-up (FAH-loh-up)
Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.
groin (groyn)
The area where the thigh meets the abdomen.
in vitro (in VEE-troh)
In the laboratory (outside the body). The opposite of in vivo (in the body).
infection (in-FEK-shun)
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
inhalation (IN-huh-LAY-shun)
In medicine, refers to the act of taking a substance into the body by breathing.
lavender (LA-ven-der)
A plant with aromatic leaves and flowers that is a member of the mint family. Oil from the flowers has been used in some cultures to treat certain medical problems, to keep insects away, and to wash in. It is also used in aromatherapy. Perillyl alcohol, a substance found in lavender, is being studied in cancer prevention and treatment. The scientific name is Lavandula angustifolia. Also called English lavender and true lavender.
malignant (muh-LIG-nunt)
Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.
nasal (NAY-zul)
By or having to do with the nose.
odor (OH-der)
A smell.
ointment (OYNT-ment)
A substance used on the skin to soothe or heal wounds, burns, rashes, scrapes, or other skin problems. Also called unguent.
phytochemical (FY-toh-KEH-mih-kul)
A substance found in plants. Some phytochemicals may reduce the risk of cancer.
pilot study (PY-lut STUH-dee)
The initial study examining a new method or treatment.
placebo-controlled (pluh-SEE-boh-kun-TROLD)
Refers to a clinical study in which the control patients receive a placebo.
prevention (pree-VEN-shun)
In medicine, action taken to decrease the chance of getting a disease or condition. For example, cancer prevention includes avoiding risk factors (such as smoking, obesity, lack of exercise, and radiation exposure) and increasing protective factors (such as getting regular physical activity, staying at a healthy weight, and having a healthy diet).
primary tumor (PRY-mayr-ee TOO-mer)
The original tumor.
quality of life (KWAH-lih-tee ... life)
The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
randomized clinical trial (RAN-duh-mized KLIH-nih-kul TRY-ul)
A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial.
regimen (REH-jih-men)
A treatment plan that specifies the dosage, the schedule, and the duration of treatment.
Roman chamomile (ROH-mun KA-muh-mile)
A type of chamomile plant with daisy-like white flowers that is found in Europe, North America, and Argentina. The dried flowers are used in teas to calm and relax, to improve sleep, and to help with stomach problems. Its essential oil (scented liquid taken from plants) is used in perfumes, shampoos, face creams, lotions, and aromatherapy. The scientific names are Chamaemelum nobile and Anthemis nobilis. Also called English chamomile.
statistically significant (stuh-TIS-tih-kuh-lee sig-NIH-fih-kunt)
Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. Also called significant.
stem cell transplant (stem sel TRANZ-plant)
A method of replacing immature blood-forming cells in the bone marrow that have been destroyed by drugs, radiation, or disease. Stem cells are injected into the patient and make healthy blood cells. A stem cell transplant may be autologous (using a patient’s own stem cells that were saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
tea tree (tee tree)
A tree that is a member of the myrtle family. Oil from the tea tree is used in shampoos and skin care products and to treat skin infections. It has been used in some cultures to treat other skin conditions, including acne, burns, and insect bites. The scientific name is Melaleuca alternifolia.
topical (TAH-pih-kul)
On the surface of the body.
vancomycin (VAN-koh-MY-sin)
An antibiotic drug used to fight resistant bacterial infections.
wound (woond)
A break in the skin or other body tissues caused by injury or surgical incision (cut).

Table of Links

1http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?idtype=5&id=441095&
;tt=0&format=2
2http://www.cancer.gov/clinicaltrials