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:
- Be published in a peer-reviewed scientific journal.
- Report on a therapeutic outcome or outcomes, such as tumor response, improvement in survival, or measured improvement in quality of life.
- Describe clinical findings in enough detail that a meaningful evaluation can be made.
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/massage | 46; 11; 18 | Mood, QOL, physical symptoms | No effect on mood, QOL, or physical symptoms | None | 1ii |
| [2] | Randomized nonblinded triala/lavender/ massage | 42; 29; 13 | Pain | No effect on pain | Improved sleep in both groups; reduced depression (in massage group); no effect on QOL | 1ii |
| [3] | Randomized nonblinded triala/chamomile/massage | 103; 43; 44 | Physical and psychological symptoms, QOL | Reduction in anxiety and in physical and psychological symptoms; improved QOL | None | 1ii |
| [4] | Randomized nonblinded triala/chamomile/massage | 52; 26; 25 | QOL, physical symptoms, anxiety | Improved QOL, fewer physical symptoms, reduced anxiety | None | 1ii |
| [5] | Randomized nonblinded triala/aromatherapy blendd/massage | 52; 34; 18 | Anxiety, mobility | Decreased anxiety, pain; improved mobility | None | 1ii |
| [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 application | 313 | Anxiety | No effect on anxiety | No effect on depression or fatigue | 1i |
| [7] | Randomized placebo-controlled double-blind trial/bergamot/ inhalation | 37; 17; 20 | Anxiety, nausea, pain in children undergoing stem cell transplant | Increased anxiety and nausea in children 1 hour after stem cell infusion in aromatherapy group; no effect on pain | Parental anxiety declined in both groups | 1iC |
| [8] | Randomized controlled single-blind trial/sweet orange/inhalation | 60; 23; 19; 18 (aromatherapy; orange tasting/sniffing; control) | Symptom intensity (nausea, retching, cough) | Greatest reduction in symptom intensity with orange tasting/sniffing | None | 1C |
| [9] | Randomized single-blind trial/choice of 20 essential oils/massage | 39; 20; 19 | Feasibility; mood | Improvements in mood in both groups (aromatherapy massage and cognitive behavioral therapy) | Preference for aromatherapy over cognitive behavior therapy | 1C |
| [10] | Randomized single-blind trial/choice of bitter orange, black pepper, rosemary, majoram, and patchouli/massage | 45; 15; 15; 15 (aromatherapy massage; plain massage; control) | Constipation; QOL | Improvement with aromatherapy massage | Improved QOL | 1C |
| [11] | Nonrandomized controlled clinical trial b/lavender, eucalyptus (Eucalyptus globulus Labill. and Eucalyptus radiata Sieber ex DC. [Myrtaceae]), and tea tree/topical application | 16; 6; 10 | Infection | No effect on incidence of infection | None | 2 |
| [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 application | 48; 24; 24 | Gastrointestinal symptoms | No effect on gastrointestinal symptoms | None | 2 |
| [13] | Consecutive case series c/lavender or chamomile/massage | 18; 8 | Anxiety, depression | No reduction in anxiety or depression | Reduction in blood pressure, pulse, and respiration | 3ii |
| [14] | Consecutive casea/various oils/massage | 69 | General symptoms | General improvement in symptoms reported by patients; no statistical analysis completed | None | 3ii |
| 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
- 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]
- 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]
- 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]
- Wilkinson S: Aromatherapy and massage in palliative care. Int J Palliat Nurs 1 (1): 21-30, 1995.
- 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.
- 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]
- 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]
- 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]
- 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]
- 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]
- Gravett P: Aromatherapy treatment for patients with Hickman line infection following high-dose chemotherapy. International Journal of Aromatherapy 11 (1): 18-9, 2001.
- Gravett P: Treatment of gastrointestinal upset following high-dose chemotherapy. International Journal of Aromatherapy 11 (2): 84-6, 2001.
- 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]
- 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.
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