Aromatherapy

Does it work ?

Systematic reviews, meta-analyses

Yim et al (2009) carried out a systematic review including six studies on aromatherapy massage in patients with depression.10 Three of these studies evaluated the benefit of Swedish massage (two with lavender oil) for depressive symptoms of cancer patients (mainly women with breast cancer). Results showed significant short term-improvement in anxiety and/or depression compared to usual care. According to the authors, this might be explained by an induction of a relaxation response in the autonomic nervous system. Earlier reviews on aromatherapy arrived at similar conclusions; however, none of which deal with the specific topic of cancer.

Clinical trials

A total of 17 clinical studies have been included in this summary.11-28 Eight are randomised controlled studies11-12,15-20, two are controlled clinical studies13,23, three are uncontrolled clinical studies21-22,25 and four are case series24 ,26-28 (see Table 1). The evidence of these trials points to a short-term benefit of aromatherapy / essential oils which could possibly last up to two weeks with reduction in anxiety and depression scores, improved sleep and an overall increase in wellbeing. Some of these trials also found an increase in patient-identified symptom relief and psychological wellbeing. However, other trials did not report any significant difference between groups. Since the comparator interventions used in the included trials vary greatly, it is not possible to assess the system and component efficacy of specific essential oils. The quality of publications ranges from mediocre to low. Double-blinding is practically impossible in the field of aromatherapy. In conclusion, existing evidence provides weak evidence suggesting that aromatherapy might have a short-term effect on anxiety and depression, and possibly on pain relief.

First author,year	Type of study	Participants (diagnosis, N)	Arms	Intervention groups	Results (sig.)	Comments
Barclay, 2006 (11)	RCT	Lymphedema, 81	2	(1) Aromatherapy and massage (2) Massage therapy alone	Increase in patient-identified symptom relief (MYMOP) after 6 months (p<0,001) and wellbeing (P=0.003)	Essential oils did not influence improvements in selected outcome measures
Chang, 2008 (20)	RCT	Terminally ill patients with various cancer types, 58	2	(1) Aromatherapy hand massage (Bergamot, Lavender, Frankincense) (2) General oil hand massage	(1) showed more significant changes in pain (P=0.001) and depression scores (P=0.000)	Aromatherapy hand massage had positive effect on pain and depression
Corner, 1995 (12)	RCT	Various types of cancer, 51	2	(1) Massage with an essential oil mix (2) Massage with carrier oil	Anxiety scores (HADS) were significantly reduced over time in the massage with essential oils group only (p<0.05)	Patients in both groups improved over time according to the symptom distress scale
Evans, 1995 (24)	Case series	Various types of cancer, 69	NA	Application of various oils and massage therapy	General improvement in symptoms reported	No p-values provided
Graham, 2003 (13)	CCT	Various types of cancer, 313	3	(1) Aromatherapy including carrier oil with fractionated oils (2) carrier oil only (3) pure essential oils (lavender, bergamot, cedar wood)	Group (2) had significantly reduced anxiety scores after treatment as measured with HADS (P=.04)	Aromatherapy as administered in this particular trial was not beneficial to cancer patients
Gravett, 2001 (21)	UCT	?	NA	Effect of essential oils such as lavender, eucalyptus (Eucalyptus globulus Labill. and Eucalyptus radiata Sieber ex DC. [Myrtaceae]), and tea tree oil was measured on incidence of infections	No effects were observed	No patient-generated data from validated outcome measures and no baseline assessment
Gravett 2001 (22)	UCT	?	NA	Orally applied 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	No effect of essential oils on cancer-related symptoms. Also, no effects on gastrointestinal symptoms	No patient-generated data from validated outcome measures and no baseline assessment
Hadfield, 2001 (25)	UCT	Malignant brain tumor, 8	NA	30 minute aromatherapy massage (lavender or Roman chamomile) and Enya music	Decrease in systolic and diastolic blood pressure, heart and respiratory rate	Semi-structured interviews carried out one week after treatment revealed that patients felt more ‘relaxed’ and ‘less tense’
Imanishi, 2009 (26)	Case series	Mamma carcinoma, 12	NA	30 min aromatherapy massage twice a week for 4 weeks	STAI was reduced after a 30 min aromatherapy massage and also reduced in 8 sequential aromatherapy massage sessions in the HADS (P=0.01)	Aromatherapy massage may ameliorated the immunologic state
Kirshbaum, 1996 (27)	Case series	Mamma carcinoma with lymphedema, 8	NA	20-30 minute aromatherapy massage with lavender oil	Reported alleviation of pain, noticeable reduction in swelling, increase in overall comfort and a feeling of relaxation	No p-values provided
Kite, 1998 (28)	Case series	Various types of cancer, 89	NA	6 sessions of aromatherapy massage	Improvement in HADS scores (P < 0.001) as well as symptoms from before baseline to after treatment	-
Louis, 2002 (23)	CCT	Various types of cancer, 17	3	(1) Water humidification (2) Aromatherapy with lavender (3) No treatment	(1) and (2) showed a small reduction in blood pressure and pulse rate; decrease in pain, anxiety, depression scores; and an increase in overall wellbeing	Repeated lavender aromatherapy sessions might increase its benefits even more. No p-values provided
Soden, 2004 (15)	RCT	Various types of cancer, 42	3	Weekly massages with (1) An essential oil and an inert carrier oil (2) An inert carrier oil only (3) No intervention	Sleep scores improved significantly in both groups (1) and (2) (P=0.02 and P=0.03); Reductions in depression scores in (2) (P=0.2)	Addition of lavender essential oil did not appear to increase the beneficial effects of massage
Stringer, 2008 (16)	RCT	Patients with haematological cancer, 39	3	20 min (1) Massage / light effleurage (stroking) moves (2) Max of 3 aromatherapy oils with carrier oil, individualized (3) Rest	Significant difference between arms in cortisol (p=0.002) and prolactin (p=0.031) levels from baseline to 30 min post-session (1) had a significantly greater reduction in prolactin than (2), (3) (p=0.031) (1) and (2) showed significant improvement in EORTC QLQ-C30 (p=0.009)	In isolated haematological oncology patients, a significant reduction in cortisol could be safely achieved through aromatherapy, with associated improvement in psychological well-being
Wilcock, 2004 (17)	RCT	Various types of cancer, 46	2	(1) Aromatherapy massage and conventional day care (2) Day care alone	No significant differences for mood, quality of life and intensity and bothersomeness of two main symptoms	Better set of outcome measures ought to be used for a larger RCT. Problem with retention of patients
Wilkinson, 1999 (18)	RCT	Various types of cancer, 103	2	(1) Aromatherapy massage (roman chamomile essential oil) (2) Carrier oil massage	Improvements were found for each group measured with STAI-state (p < 0.001). Scores of group (1) improved on all RSCL subscales at the 1% level of significance or better: psychological (p < 0.001), quality of life (p < 0.01), severe physical (p < 0.05), and severe psychological (P < 0.05), except for severely restricted activities	Massage with or without essential oils appeared to reduce levels of anxiety. The addition of an essential oil seems to enhance the effect of massage and to improve physical and psychological symptoms, as well as overall quality of life
Wilkinson, 2007 (19)	RCT	Various types of cancer and clinical diagnosis of anxiety and/or depression, 288	2	(1) Aromatherapy massage (2) Standard care	Group (1) showed significant improvement in clinical anxiety and/or depression compared with (2) at 6 weeks (P=0.1), but not at 10 weeks post randomization. (1) also described greater improvement in self-reported anxiety at both 6 and 10 weeks post-randomization (P=0.04 and P=0.04)	Aromatherapy massage did not appear to confer benefit on cancer patients’ anxiety and/or depression in the long-term, but may be associated with clinically important benefit up to 2 weeks after the intervention

« What is it ?

Is it safe ? »

Citation

Katja Boehm, Thomas Ostermann, CAM-Cancer Consortium. Aromatherapy [online document]. http://www.cam-cancer.org/CAM-Summaries/Herbal-products/Aromatherapy. March 11, 2011.

Document history

Summary currently being updated.
Summary first published in March 2011, authored by Katja Boehm and Thomas Ostermann.

References

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