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Aromatherapy and Essential Oils (PDQ®)

  • Last Modified: 10/16/2012

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Summary of the Evidence for Aromatherapy and Essential Oils

To assist readers in evaluating the results of human studies of complementary and alternative medicine (CAM) treatments for people with cancer, the strength of the evidence (i.e., the levels of evidence) associated with each type of treatment is provided whenever possible. To qualify for a level of evidence analysis, a study must:

Separate levels of evidence scores are assigned to qualifying human studies on the basis of statistical strength of the study design and scientific strength of the treatment outcomes (i.e., endpoints) measured. The resulting two scores are then combined to produce an overall score. A table showing the levels of evidence scores for qualifying human studies cited in this summary is presented below. For an explanation of the scores and additional information about levels of evidence analysis of CAM treatments for people with cancer, refer to Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.

Use of Aromatherapy as a Supportive Care Agent in Cancer and Palliative Care: Table of Clinical Studies
Reference Citations Type of Study/Essential Oil/Mode of Administration No. of Patients Enrolled; Treated; Control Condition Investigated Primary Outcome Secondary Outcome Level of Evidence Score 
[1]Randomized nonblinded triala/lavender (Lavandula angustifolia Miller [synonyms: Lavandula spicata L.; Lavandula vera DC.]) and chamomile blend/massage46; 11; 18Mood, QOL, physical symptomsNo effect on mood, QOL, or physical symptomsNone1ii
[2]Randomized nonblinded triala/lavender/ massage42; 29; 13PainNo effect on painImproved sleep in both groups; reduced depression (in massage group); no effect on QOL1ii
[3]Randomized nonblinded triala/chamomile/massage103; 43; 44Physical and psychological symptoms, QOLReduction in anxiety and in physical and psychological symptoms; improved QOLNone1ii
[4]Randomized nonblinded triala/chamomile/massage52; 26; 25QOL, physical symptoms, anxietyImproved QOL, fewer physical symptoms, reduced anxietyNone1ii
[5]Randomized nonblinded triala/aromatherapy blendd/massage52; 34; 18Anxiety, mobilityDecreased anxiety, pain; improved mobilityNone1ii
[6]Double-blind randomized control triala/lavender, bergamot (Citrus aurantium L. ssp. bergamia [Risso] Wright & Arn. [Rutaceae]; [synonym: Citrus bergamia Risso]), and cedarwood (Cedrus atlantica [Endl.] Manetti ex Carriere [Pinaceae])/indirect application313AnxietyNo effect on anxietyNo effect on depression or fatigue1i
[7]Randomized placebo-controlled double-blind trial/bergamot/ inhalation37; 17; 20Anxiety, nausea, pain in children undergoing stem cell transplantIncreased anxiety and nausea in children 1 hour after stem cell infusion in aromatherapy group; no effect on painParental anxiety declined in both groups1iC
[8]Randomized controlled single-blind trial/sweet orange/inhalation60; 23; 19; 18 (aromatherapy; orange tasting/sniffing; control)Symptom intensity (nausea, retching, cough)Greatest reduction in symptom intensity with orange tasting/sniffingNone1C
[9]Randomized single-blind trial/choice of 20 essential oils/massage39; 20; 19Feasibility; moodImprovements in mood in both groups (aromatherapy massage and cognitive behavioral therapy)Preference for aromatherapy over cognitive behavior therapy1C
[10]Randomized single-blind trial/choice of bitter orange, black pepper, rosemary, majoram, and patchouli/massage45; 15; 15; 15 (aromatherapy massage; plain massage; control)Constipation; QOLImprovement with aromatherapy massageImproved QOL1C
[11]Nonrandomized controlled clinical trial b/lavender, eucalyptus (Eucalyptus globulus Labill. and Eucalyptus radiata Sieber ex DC. [Myrtaceae]), and tea tree/topical application16; 6; 10Infection No effect on incidence of infectionNone2
[12]Nonrandomized controlled clinical trial b/geranium (Pelargonium species), German chamomile (Matricaria recutita L. [synonyms: Matricaria chamomilla L., Chamomilla recutita (L.) Rausch.]), patchouli (Pogostemon cablin [Blanco] Benth. [Lamiaceae] [synonyms: Mentha cablin Blanco, Pogostemon patchouly Letettier]), and turmericphytol/oral application48; 24; 24Gastrointestinal symptomsNo effect on gastrointestinal symptomsNone2
[13]Consecutive case series c/lavender or chamomile/massage18; 8Anxiety, depressionNo reduction in anxiety or depressionReduction in blood pressure, pulse, and respiration3ii
[14]Consecutive casea/various oils/massage69General symptomsGeneral improvement in symptoms reported by patients; no statistical analysis completedNone3ii

No. = number; QOL = quality of life.
aPatients with cancer.
bPatients with breast cancer undergoing bone marrow transplantation.
cPatients with malignantbrain tumors.
dLavender (43%), rosewood (29%), rose (7%), and valerian (4%).

References
  1. 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]

  2. 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]

  3. 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]

  4. Wilkinson S: Aromatherapy and massage in palliative care. Int J Palliat Nurs 1 (1): 21-30, 1995. 

  5. Corner J, Cawler N, Hildebrand S: An evaluation of the use of massage and essential oils on the wellbeing of cancer patients. Int J Palliat Nurs 1 (2): 67-73, 1995. 

  6. 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]

  7. 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 21 (3): 247-54, 2012.  [PUBMED Abstract]

  8. 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]

  9. Serfaty M, Wilkinson S, Freeman C, et al.: The ToT study: helping with Touch or Talk (ToT): a pilot randomised controlled trial to examine the clinical effectiveness of aromatherapy massage versus cognitive behaviour therapy for emotional distress in patients in cancer/palliative care. Psychooncology 21 (5): 563-9, 2012.  [PUBMED Abstract]

  10. Lai TK, Cheung MC, Lo CK, et al.: Effectiveness of aroma massage on advanced cancer patients with constipation: a pilot study. Complement Ther Clin Pract 17 (1): 37-43, 2011.  [PUBMED Abstract]

  11. Gravett P: Aromatherapy treatment for patients with Hickman line infection following high-dose chemotherapy. International Journal of Aromatherapy 11 (1): 18-9, 2001. 

  12. Gravett P: Treatment of gastrointestinal upset following high-dose chemotherapy. International Journal of Aromatherapy 11 (2): 84-6, 2001. 

  13. 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]

  14. Evans B: An audit into the effects of aromatherapy massage and the cancer patient in palliative and terminal care. Complement Ther Med 3 (4): 239-41, 1995.