Common scents for healing

We get first look at major new study that says aromatherapy really helps cancer patients

Simon Crompton

Aromatherapy can significantly lift anxiety and depression. It’s the sort of statement you see on alternative-therapy websites and pamphlets for practitioners who massage fragrant oils into people’s skin. And you’ve probably always suspected that there was little to back it up.

Today all that changes. According to an authoritative study by Cancer Research UK, in the latest issue of the Journal of Clinical Oncology, that assertion is true. The new study is significant, and not just because it indicates that after chemotherapy and other treatment, aromatherapy helps to relieve anxiety and depression much quicker than other approaches.

The researchers believe it is the first large randomised controlled trial (the highest standard of research, which doctors take most seriously) to be conducted on a complementary therapy in several centres in the NHS. And it indicates that health service workers and research funders are beginning to take seriously the potential contribution of complementary medicines. “I think it’s enormously exciting,” says the lead researcher, Amanda Ramirez, the director of the Cancer Research UK London Psychosocial Group at King’s College London. “I’m unaware of other treatments, including talking therapies, that can achieve such fast improvements in people with cancer who are anxious or depressed.”

The study, which cost £300,000 (most multi-centre trials cost £500,000), examined 288 people with all types of cancer and at various stages of the disease who had had anxiety or depression diagnosed after treatment. Many had severe symptoms such as panic attacks, inability to sleep and needle phobia. Recent studies have indicated that about half of cancer sufferers get some such problems in the first year. Half of the subjects in the trial received a course of weekly aromatherapy massage and half received normal support services, such as counselling and, in severe cases, psychotherapy and medication. Their symptoms were monitored for 12 weeks.

The results were so clear that they surprised Ramirez, a professor of psychiatry. Symptoms lifted far earlier in the aromatherapy group than in the nonaromatherapy group; within two weeks of the treatment beginning as opposed to six weeks. And although by ten weeks after the trial started the two groups showed equal alleviation of symptoms, members of the group receiving aromatherapy consistently reported more improvement in anxiety than the other group right though the trial. However, aromatherapy seemed to bring no significant improvement to pain, fatigue, nausea and vomiting.

The trial didn’t separate out the different elements of aromatherapy — touch, specific scents (of which 20, including bergamot and lavender, were used in the trial), time with an understanding therapist — or attempt to explain which had the beneficial effect. The trial took a cross-section of practitioners so that it was the therapy not the therapist being evaluated.

“The results show that aromatherapy really accelerates the improvement in anxiety and depression,” says Ramirez. “And when you consider that many people in the trial had a limited life expectancy, that acceleration is a huge gain to health and wellbeing.” Around one in three cancer patients tries complementary therapies. Aromatherapy and massage are popular, and reported benefits prompted Ramirez and cancer specialists from Mount Vernon Hospital, Mid-dlesex, to get the trial rolling in 1998.

They knew that health service managers are generally unwilling to pay for treatments such as aromatherapy because of the lack of evidence proving its benefits. But the results of the new trial, also supported by Marie Curie Cancer Care, Macmillan Cancer Support and Dimbleby Cancer Care, may help to put aromatherapy on a similar footing to treatments such as physio-therapy, which are available on the NHS.

A smaller but authoritative trial had already indicated that aromatherapy can bring a significant reduction in agitation in people with dementia. A review of evidence in 2004 by the respected Cochrane Collaboration said that although massage and aromatherapy seemed to improve wellbeing in cancer patients, evidence was mixed and larger trials into their effect on anxiety were needed. This new study helps to fill that gap.

Andy Ritchie, the chair of the National Cancer Research Institute Group on Complementary Therapy, said the findings were impressive and reliable. “They demonstrate that professional research can be conducted in complementary therapies.”

For Ramirez, 48, there was an added significance to the trial. Shortly after it began, she was told she had breast cancer. Knowing of the benefits that many patients had claimed for aromatherapy, she decided to try it in the weeks that she was having chemotherapy. “In the face of those strong drugs, it felt relaxing, like a balm. But it also felt powerful, almost like an antidote to the poisons in my body.” She has been clear of cancer for five years, and is relieved that her fear that she would never get back to her research has not been realised.

For more information on aromatherapy and cancer visit www.cancerhelp.org.uk

Aromatherapy What is it? Essential oils extracted from plants are believed to have therapeutic properties. Selected oils - such as lavender, chamomile and tea tree - are massaged into the skin, put in baths or inhaled. The term aromatherapy was coined in the 1930s by René-Maurice Gattefosse, a French chemist.

Claims to help relieve stress-related problems such as anxiety, high blood pressure and insomnia.

WHAT’S THE EVIDENCE?

DR TOBY MURCOTT

Is aromatherapy now a proven treatment?

No, this study provides good-quality evidence that aromatherapy can relieve anxiety in cancer patients. It says nothing about its effectiveness for other conditions.

Which bit of the treatment worked?

Separate studies suggest that aroma, massage and a sympathetic ear can all relieve anxiety. This research, though, looked at all three together and hints that aromatherapy may be more than the sum of its parts. Clinical research typically copes best with studying one thing at a time, often breaking down a treatment into its components. Many complementary practitioners argue that this is unworkable with their therapies. This research lends weight to that argument but is not conclusive.

Is it safe?

Plant essential oils can contain chemicals that might have a direct effect on the patient or react with prescription medicines. One possible benefit of this research is a more open discussion of any hazards. Complementary therapies are often seen as outside medicine and there is some evidence that patients are reluctant to discuss them with doctors.

Dr Toby Murcott is a former BBC science correspondent