No studies in the published peer-reviewed literature discuss aromatherapy as a treatment for 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.

A review undertaken in 2004 investigated whether aromatherapy and/or massage decreased psychological morbidity, lessened symptom distress, or improved quality of life in cancer patients.[2] The review reported that the most consistently found effect of massage or aromatherapy massage was on anxiety, with four of the trials (a total of 207 patients) reporting a reduction in anxiety. The authors state that contradictory evidence exists on whether any additional benefit on anxiety is conferred by the addition of aromatherapy. Of three trials that examined depression in cancer patients, only one reported significant differences. Two trials reported a reduction in nausea and three reported a reduction in pain. The authors concluded that on the basis of limited evidence, massage and aromatherapy confer short-term benefits on psychological well-being; however, evidence is mixed on whether aromatherapy itself enhances the effect of massage.

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.[3] 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 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.[4] 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.[5] 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).[6] 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.

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.[7] 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.[8] 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 undematured ethanol (69.7%) are being investigated against MRSA in vitro . No clinical trials have been performed.[9]

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. There was no significant difference between treatment regimens (Fisher's exact test; P = .0286). 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.[10]

References

1. Cooke B, Ernst E: Aromatherapy: a systematic review. Br J Gen Pract 50 (455): 493-6, 2000.  [PUBMED Abstract]
   
   
2. Fellowes D, Barnes K, Wilkinson S: Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database Syst Rev (2): CD002287, 2004.  [PUBMED Abstract]
   
   
3. 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]
   
   
4. 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]
   
   
5. 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]
   
   
6. 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]
   
   
7. 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]
   
   
8. 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]
   
   
9. 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]
   
   
10. 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

Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. Also called adjunct therapy.

A drug used to treat infections caused by bacteria and other microorganisms.

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.

A drug used in the treatment of anxiety and muscle spasms.

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.

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.

The underarm or armpit.

A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.

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.

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).

The growth of abnormal cells in the tissues of the brain. Brain tumors can be benign (non-cancerous) or malignant (cancerous).

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is 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.

An oil with little or no scent that is used to dilute or “carry” essential oils (scented liquid taken from plants).

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.

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.

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.

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving.

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.

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.

The area where the thigh meets the abdomen.

In the laboratory (outside the body). The opposite of in vivo (in the body).

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.

In medicine, refers to the act of taking a substance into the body by breathing.

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.

Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.

A treatment in which the soft tissues of the body are kneaded, rubbed, tapped, and stroked. Massage therapy may help people relax, relieve stress and pain, lower blood pressure, and improve circulation. It is being studied in the treatment of cancer symptoms such as lack of energy, pain, swelling, and depression.

A disease or the incidence of disease within a population. Morbidity also refers to adverse effects caused by a treatment.

By or having to do with the nose.

A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.

A smell.

A substance used on the skin to soothe or heal wounds, burns, rashes, scrapes, or other skin problems. Also called unguent.

A substance found in plants. Some phytochemicals may reduce the risk of cancer.

The initial study examining a new method or treatment.

Refers to a clinical study in which the control patients receive a placebo.

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).

The original tumor.

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.

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.

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.

A treatment plan that specifies the dosage, the schedule, and the duration of treatment.

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.

In statistics, describes a mathematical measure of difference between groups. The difference is said to be significant if it is greater than what might be expected to happen by chance alone. Also called statistically significant.

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.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

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.

On the surface of the body.

An antibiotic drug used to fight resistant bacterial infections.

A break in the skin or other body tissues caused by injury or surgical incision (cut).