NEW YORK-Aromatherapy massage reduces short-term anxiety in cancer patients, improves quality of life (QOL), and is perceived by cancer patients as being beneficial, according to results to date from evaluations conducted by researchers in the United Kingdom.
NEW YORKAromatherapy massage reduces short-term anxiety in cancer patients, improves quality of life (QOL), and is perceived by cancer patients as being beneficial, according to results to date from evaluations conducted by researchers in the United Kingdom.
"This is one example of a therapy which certainly appears to be helping patients cope and live with cancer," said Susie Wilkinson, PhD, RN, head of palliative care research/senior lecturer in palliative care, Marie Curie Palliative Care Research and Development Unit, London. She spoke at a conference sponsored by Gilda’s Club Worldwide and Marie Curie Cancer Care.
An ongoing study of aromatherapy massage is notable because it is one of the few carefully designed evaluations of the effects of complementary therapies on cancer patients, Dr. Wilkinson said.
Cancer patients seek complementary therapies for a variety of reasons, such as failure of conventional treatment to produce a cure, adverse effects of chemotherapeutic regimens, lack of time and attention from busy practitioners, and, very often, dissatisfaction with the technical approach to treatment.
"Patients want to be able to explore these other approaches with their medical practitioners," Dr. Wilkinson said. "They want to be treated by doctors who see them more as a whole person."
Complementary therapies can also make cancer patients feel empowered that they have been able to do something for themselves. Aromatherapy massage, now commonly used in all Marie Curie Cancer Care hospices, may be one such empowering treatment, giving patients something they can choose to do about their mood. Studies show that between 23% and 40% of cancer patients suffer from clinically significant anxiety or depression.
Aromatherapy Pilot Study
Aromatherapy massage involves the use of essential oils, or fragrant essences distilled from plants, that are combined with carrier oils and rubbed into the skin.
"When we set up this aromatherapy service within Marie Curie Cancer Care, we knew that if we did not have some idea of what was happening, we would not be allowed to continue to use it," Dr. Wilkinson said.
To evaluate the effectiveness of aromatherapy massage, the researchers set up a pilot study of 100 consecutive cancer patients (predominantly breast cancer) randomized to receive full body massage with essential oils plus carrier oils, or massage with carrier oils alone. Treatment duration was three massages over a 3-week period.
Thirteen patients died before completing the intervention. For the remaining 87 patients, massage (with or without essential oils) appeared to decrease anxiety. Before the first massage, patients randomized to massage with carrier oils alone had a mean score of 44.73 on the State/Trait Anxiety Inventory; the score dropped to 30.27 postmassage (P < .0001). Similar drops were seen following the second and third massage.
In the massage with aromatherapy group, mean scores dropped from 48.37 to 33.88 in the first session (P < .0001), with similar drops in the second and third sessions.
One "surprising" result was that the aromatherapy group did much better than the carrier oils only group on overall quality of life score as measured by the Rotterdam Symptom Control Checklist, Dr. Wilkinson said.
Ongoing Multicenter Study
The findings on quality of life prompted the researchers to seek funding from the Cancer Research Campaign (now Cancer Research UK) for a randomized, controlled, multicenter trial evaluating the effectiveness of aromatherapy massage on quality of life in patients with cancer.
This more rigorous trial involves five UK cancer centers and will include 258 patients with moderate to severe anxiety or depression randomized to immediate or delayed treatment arms. The immediate treatment arm consists of four weekly 1-hour aromatherapy massage sessions and 6 subsequent weeks of follow-up; the delayed treatment arm is no intervention for 10 weeks, followed by four aromatherapy massage sessions outside the study.
Outcomes measures include a variety of validated questionnaires that capture anxiety and depression data. In addition, researchers are documenting patient perception of the intervention.
The aromatherapy trial is still accruing patients, and final data on anxiety and depression and QOL measures are expected by Sept. 2002. The researchers’ qualitative data so far suggest that patients at least perceive a variety of important physical and psychological benefits. Some felt the massage helped with pain and reduced the need for pain-killing drugs, while others felt they slept better after therapy. Many emphasized the feeling of relaxation during and following massage, and some indicated that the intervention enabled them to better cope with the stress they were undergoing.
Whatever the final results of this trial, it will enhance the scientific foundation for using or not using complementary therapies, simply because virtually no other randomized, controlled trials exist. "We need many more studies looking at all the complementary therapies," Dr. Wilkinson said.