AROMATHERAPY AND BREAST CANCER
Benefits of Aromatherapy in Support of Pharmacological Treatments for Breast Cancer By Wendy L. Wheeler
1
AROMATHERAPY AND BREAST CANCER
2
ABSTRACT No other illness affects the body more profoundly than cancer. With no clear scientific evidence that aromatherapy can cure or prevent cancer, there is research that aromatherapy as a complementary therapy is effective for cancer and other types of illness. Aromatherapy improves the quality of life for the patient. Cancer patients have reported that the use of aromatherapy aids in the healing of scars from surgery, reduces stress, assists sleep and relieves side effects from chemotherapy and radiation treatments including, but not limited to, nausea, headaches and digestive issues. Aromatherapy naturally assists pharmacological cancer treatments by creating a healthy immune system and improves the overall quality of life in patients. The objective of this paper is to reveal research to support the benefits of aromatherapy in support of pharmacological treatments for breast cancer. ABOUT AROMATHERAPY Aromatherapy, also referred to as Essential Oil therapy, can be defined as the art and science of utilizing in naturally extracted aromatic essences taken from the roots, leaves, seeds, or blossoms of plants to balance, harmonize and promote the health of body, mind and spirit. It seeks to unify physiological, psychological and spiritual processes to enhance an individual’s innate healing process [1]. Essential oils are distilled or expressed aromatic extracts from a wide range of aromatic/medicinal plants. Each essential oil consists of 2 to 200+ individual chemical components all working in synergy to provide a range of therapeutic properties and each essential oils unique aroma. Within the plant, essential oils serve to protect/defend, attract and heal [1]. Pure essential oils are approximately 70 times more concentrated than the whole plant [13]. Aromatherapy is generally used in two ways: NOTE: Essential oils are not recommended to be taken internally. 1. Inhalation: Airborne molecules travel into the nose and reach the olfactory bulb of the cranial nerve before entering the limbic system of the brain. From the limbic system, odor messages go to the hypothalamus, which sends messages to the other parts of the brain (pituitary, pineal and amygdala) and body, stimulating the autonomic nervous system (ANS), endocrine system, organ functions, secretions of antibodies, neurotransmitters, hormones and enzymes throughout the body. Smell includes direct inhalation of essential oils from the bottle, palm inhalation, inhalers, aromatherapy jewelry, on a cotton ball or tissue and aerial diffusion which distributes molecules into the air. [2] 2. Topical applications allow the essential oils to absorb through the skin into the body tissue. Applications include massage, lotions, oils, in the bath, compresses and salves.
WHAT IS BREAST CANCER Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancerous) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to
AROMATHERAPY AND BREAST CANCER
3
distant areas of the body. Breast cancer occurs almost entirely in women, but men can get it, too [3].
TYPICAL PHARMACOLIGICAL BREAST CANCER TREATMENT There are several ways to treat breast cancer, depending on its type and stage. [3]. These treatments are invasive and cause severe side effects. 1. Local treatments: Some treatments are called local therapies, meaning they treat the tumor without affecting the rest of the body. Types of local therapy used for breast cancer include: a. Surgery b. Radiation therapy 2. Systemic treatments: Breast cancer can also be treated using drugs, which can be given by mouth or directly into the bloodstream. These are called systemic therapies because they can reach cancer cells anywhere in the body. Depending on the type of breast cancer, several different types of drugs might be used, including: a. Chemotherapy b. Hormone therapy c. Targeted therapy
AROMATHERAPY: A COMPLEMENTARY THERAPY FOR BREAST CANCER PATIENTS Complementary therapy is defined as therapeutic disciplines that are used together with conventional medicine. Using aromatherapy in addition to usual care helps lessen a patient's discomfort following surgery. Essential oils have been used since early humanity by various cultures as a natural remedy for virtually every disease. Up to 75 percent of people in the United States use complementary and alternative medicine (CAM) on a regular basis, and many of these people do so in order to fight cancer. [13] While treating cancer by modern medicine the focus is more on the ailment and not the person. Factors like pain, stress, anxiety, fatigue, fear of death, depression may be overlooked by the treating physicians. Quality of life encompasses the physical, psychosocial, social and spiritual dimensions of life lived by a person. Cancer pain is one of the physical components and has tremendous impact on the quality of life of the patient. Aggressive surgeries, radiotherapy and chemotherapy focus more on prolonging the survival of the patient failing to realize that the quality of life lived also matters equally [9]. Aromatherapy as a complementary therapy with modern medical treatment can improve the general well-being in cancer patients when applied either to the skin through massage, added to baths or inhaled [9]. Some patients receiving aromatherapy have reported improvement in symptoms such as nausea or pain, and have lower blood pressure, pulse, and respiratory rates [14]. Benefit include reduced anxiety levels and relief of emotional stress, pain, muscular tension and fatigue and reduce the side effects of chemotherapy and radiation treatments [6]. Essential oils have been helpful when used during radiotherapy to help reduce or prevent deep burning and scarring [9].
AROMATHERAPY AND BREAST CANCER
4
THE ROLE OF AROMATHERAPY FOR BREAST CANCER When considering aromatherapy as a complementary treatment for breast cancer, or any illness, consult your treating physician to assess any potential risks and benefits. Use aromatherapy with care and under the supervision of a licensed practitioner who has advanced training in the use of aromatherapy for cancer patients. Studies indicate that the following list of essential oils offer positive effects in complementary treatments for breast cancer [18]: • Black Pepper (Piper nigrum): treatment of pain relief, rheumatism, chills, flu, colds, exhaustion and muscular aches. Precautions: Do not use in conjunction with homeopathic treatment. Do not use in the bath. Generally non-toxic if used in moderation, excessive use may stress the kidneys. Use in low dilution and extreme moderation in pregnancy. • Cardamom (Elettaria cardamomum): helpful for the digestive system, laxative and relieves nausea. Precautions: High in 1, 8-cineole. it is not recommended for children under 2 because it can cause CNS and breathing problems. • Frankincense (Boswellia carterii, sacra or serrata): builds immunity, reduces inflammation, heals age spots, supports brain and fights cancer. Precautions: Not for pregnancy or nursing. • Ginger (Zingiber officinale): reduces inflammation, supports joints, improves digestion and relieves nausea. Precautions: Not for use in bath. Not for pregnancy or nursing. Not for sensitive skin – may be an irritant and need to be applied diluted. Do not use if taking Anticoagulant medications. • Helichrysum (Helichrysum italicum or splendidum): skin healing properties, treats burns, sun damaged skin and minimize scars. Precautions: No noted precautions. • Lavender (Lavandula angustifolia): used to relieve stress, treat depression, promote sleep, reduce inflammation and heals burns and cuts. Precautions: Do not use with low blood pressure. During pregnancy you can use from third trimester onward; use in moderation and low dilution (1% or less). Safe to use with children; use in moderation and low dilution (1% or less). • Oregano (Origanum vulgare L.): powerful anti-microbial properties, can kill fungus and help you kick a cold fast. Precautions: Not for use in bath. Not for children under 5 years. Not for pregnancy or nursing. Not for sensitive skin – may be an irritant and need to be applied diluted. • Peppermint (Mentha piperita): supports digestion including nausea and vomiting, improves focus, boosts energy, fever reducer, headache and muscle pain relief. Precautions: Avoid during pregnancy. Not for children under 5. Not for use in the bath. Possible skin sensitivity; due to the high menthol content. Use in moderation and with a carrier oil or lotion for sensitive skin areas or the face. Not compatible with homeopathic remedies. Peppermint is cooling and stimulating in nature, may be too much four hours before bed. DO NOT USE IF TAKING 5-fluorouracil (an anti-cancer drug), Cyclosporine and Cytochrome. • Rosemary (Rosmarinus officinalis): stimulates cell renewal, improves circulation, treats dull dry skin by fighting bacteria and regulating oil secretions. Precautions: Avoid during pregnancy. Not for children under 5. Do not use with epilepsy. Do not use with high blood pressure. Do not use with homeopathic remedies. Stimulating in nature and may be too much four to six hours before sleeping. • Thyme (Thymus zygis): antiseptic qualities, raises poor circulation, diarrhea, exhaustion, depression and is an immune stimulant for infection. Precautions: Avoid during pregnancy.
AROMATHERAPY AND BREAST CANCER
5
High blood pressure Thyme contains phenols, which will irritate mucous membranes, causing dermal irritation and sensitization in some cases. Use in moderation and in a low dilution. ‘Linalool’ type is generally less toxic, non-irritating with less possibility of sensitization. Linalool chemo type is safe to use for children and is more of an immune stimulant than an antibacterial
ESSENTIAL OIL PRECAUTIONS FOR BREAST CANCER Essential oils have such an extremely high level of herbal and chemical concentration, there is more concern for safety with chronic illness, including cancer. Breast cancer patients should avoid the essential oils listed in Table 1: History of Estrogen-Dependent Cancer and note the precautions for other types of cancer. TABLE 1: ESSENTIAL OILS TO AVOID WITH CANCER Example: If you currently have breast cancer avoid essential oils listed in both columns “If Cancer is Present” and “History of Estrogen-Dependent Cancer”. If Cancer is Present History of Estrogen-Dependent Cancer History of Skin Cancer Prostate Cancer Basil Aniseed Lemon Verbena Ajowan Lemon Pine Ocimum basilicum Pimpinella anisum Aloysia citriodora Trachyspermum Verbena Pinus ammi Aloysia sylvestris citriodora Bay Laurel Basil Myrrh Angelica Root Lime Laurus nobilis Ocimum basilicum Angelica Citrus Commiphora archangelica aurantifolia myrrha Clove Syzygium aromaticum
Rose Rosa damascena
Basil Ocimum basilicum
Cinnamon Cinnamomum verum and zeylanicum
Chamomile Chamaemelum nobile a.k.a. Anthemis nobilis Citronella Cymbopogon nardus
Sage Salvia officinalis
Bergamot Citrus bergamia
Fennel Foeniculum vulgare
Clary Sage Salvia sclarea
Star Anise Illicium verum
Grapefruit Citrus paradisii
Ho Leaf Cinnamomum camphora
Cypress Cupressus sempervirens
Tarragon Artemisia dracunculus
Lemon Citrus limonum
Nutmeg Myristica fragrans
Fennel Foeniculum vulgare
Vitex Vitex agnus castus
Star Anise Illicium verum
Geranium Pelargonium graveolens
Yarrow Achillea millefolium
Jasmine Jasminum officinale
Mandarin Citrus reticulata or deliciosa Melissa Melissa officinalis Orange Citrus sinensis Tarragon Artemisia dracunculus
AROMATHERAPY AND BREAST CANCER
6
For a person about to be exposed to the intense rays of radiation therapy, it is important to avoid phototoxic (light/sun sensitivity) oils topically to not worsen skin sensitivity. Phototoxic essential oils are listed in Table 2. TABLE 2: PHOTOTOXIC ESSENTIAL OILS - AVOID WITH RADIATION THERAPY Ajowan (Trachyspermum ammi) Mandarin (Citrus reticulata or Grapefruit (Citrus paradisii) deliciosa) Angelica Root (Angelica Lemon (Citrus limonum) Melissa (Melissa officinalis) archangelica) Basil (Ocimum basilicum) Lemon Verbena (Aloysia citriodora) Orange (Citrus sinensis) Tarragon (Artemisia dracunculus) Bergamot (Citrus bergamia) Lime (Citrus aurantifolia)
COMPLEMENTARY AROMATHERAPY FOR BREAST CANCER Using aromatherapy for all stages from the diagnosis to after treatments is essential to assist the cancer patient to accept the diagnosis and sustain the trauma involved in the treatment. Initial Stages of Diagnosis Upon hearing the preliminary diagnosis of cancer feelings of fear, shock and denial may overpower the mind. Essential oils like Lavender (Lavandula angustifolia), Neroli (Citrus aurantium var. amara) and Petitgrain (Citrus aurantium var. amara) can help battle the initial waves of emotional distress, while providing the patient with strength and clarity to overcome the challenges of the time ahead [21]. Healing Emotionally and Physically Throughout Treatments One of the most challenging aspects of cancer is keeping the patient comfortable while remaining positive. Good emotional health is important for both the patient and their support system. Following are some recommended aromatherapy treatments for emotional and physical well-being. •
• •
•
Depression: is one of the most common after-effects of cancer. This depression often reaches its peak due to the medicines used and the rigors of post-operative therapies [21]. Essential oils like Lavender (Lavandula angustifolia), Rhododendron (Rhododendron anthopogon) and Thyme (Thymus zygis) are especially good at balancing the central nervous system. Healing Incision Sites: Helichrysum (Helichrysum italicum) can be used almost immediately after the surgery to encourage new skin cell growth and minimize the scars [21]. Chemotherapy: breaks down good blood cells while destroying cancer cells. Frankincense (Boswellia carterii, sacra or serrata), Rosemary (Rosmarinus officinalis) and Thyme (Thymus zygis) can help rebuild white blood cells and can be inhaled from the bottle or a diffuser. Radiation: can easily damage the vital body organs and the skin, so the use of gentle, antioxidant essential oils in combination with proper nutrition can help minimize the damage. Use Frankincense (Boswellia carterii, sacra or serrata), Helichrysum (Helichrysum italicum or splendidum), Lavender (Lavandula angustifolia) or Peppermint (Mentha piperita) topically by diluting with a carrier oil and massaging on the affected area.
AROMATHERAPY AND BREAST CANCER
•
•
•
• •
7
Neuritis (nerve inflammation) is another common side effect of radiation and can be treated with Lavender (Lavandula angustifolia). Mix with a carrier oil directly to affected areas 3-5 times each day. This can also be used with a cold compress on affected location 2-3 times each day [21]. For severe inflammation use a low dilution (1% or less) of Oregano (Origanum vulgare L.) for the first day only. Stomach upset and nausea are common side effects of both radiation and chemotherapy treatments and can be relieved by using Cardamom (Elettaria cardamomum), Ginger (Zingiber officinale) and/or Peppermint (Mentha piperita). Can be inhaled and used topically [21]. Headache: Use essential oils like Frankincense (Boswellia carterii, sacra or serrata), Lavender (Lavandula angustifolia), Peppermint (Mentha piperita) and Rosemary (Rosmarinus officinalis). These can be applied topically by diluting with a carrier oil, inhaled and diffused. Energy Boost: Chronic fatigue is a side effect of treatments and from depression. Use Black Pepper (Piper nigrum) and Thyme (Thymus zygis) in a diffuser to combat exhaustion. Relaxation or Trouble Sleeping: An overactive mind is common with any serious illness. Diffuse Lavender (Lavandula angustifolia) and Rhododendron (Rhododendron anthopogon).
ESSENTIAL OILS AS AN ALTERNATE THERAPY FOR BREAST CANCER There is promising research when it comes to the use of essential oils and aromatherapy as an alternate therapy for breast cancer patients meaning the use of essential oils to treat cancer. According to research from the National Institute of Health (NIH), Frankincense (Boswellia sacra) reduces breast cancer tumors in vitro (test tube) test methods and models based on human cell and tissue cultures. Boswellia sacra essential oil induces breast cancer cellspecific cytotoxicity. Suppression of cellular network formation and disruption of spheroid development of breast cancer cells by Boswellia sacra essential oil suggest that the essential oil may be effective for advanced breast cancer [10]. The following exerts from the American Journal of Cancer Research: Anticancer Activity of Essential Oils and Their Chemical Components - A Review offers hope of one day using essential oils as an alternate cancer treatment. “Plants are hence a potential source of drug discovery and development of cancer chemoprevention or treatment. They could thus provide a hope for finding anticancer molecules available and efficient for the treatment of persons with cancer. This review shows that more and more studies are necessary to carry out on the anticancer activity of essential oils (EOs) as nature is a rich source of biological and chemical diversity. Cytotoxicity has been reported for many EOs. Nobody could deny that chemotypes of EOs have a wide spectrum of action on various therapies, even though the molecular mechanisms and events need to be identified as well. The joint activity between chemistry, biochemistry, biology, medicine, pharmacy and botany to correctly identify these chemical constituents is thus fundamental. Finding new active EOs for the treatment of cancers is a challenge. Using it in Humans to treat is promise [11].”
AROMATHERAPY AND BREAST CANCER
8
CONCLUSION Today, aromatherapy cannot be a substitute to pharmacological cancer treatments – however, it can be used successfully as a complementary therapy. Aromatherapy supports the immune system and the body’s healing responses both physically and emotionally during breast cancer treatments. Additional research is needed to further assess suitable essential oil blends and applications for the use of aromatherapy as a complementary therapy for breast cancer.
AROMATHERAPY AND BREAST CANCER
9
Works Cited 1
The National Association for Holistic Aromatherapy, (2015). Explore Aromatherapy, p. 2.
2
Dechen, S., (2016). Clinical Aromatherapy Level 1 Text, Aroma Apothacary Healing Arts Academy, p. 27-29
3
American Cancer Society: Complementary and Alternative Cancer Therapies. http://www.cancer.org/cancer/breastcancer/detailedguide/
4
Cancer Research UK, (n.d.) Aromatherapy, http://www.cancerresearchuk.org
5
Medical News Today, http://www.medicalnewstoday.com/articles/10884.php
6
Boehm K, Büssing A, Ostermann T. Aromatherapy as an Adjuvant Treatment in Cancer Care — A Descriptive Systematic Review. African Journal of Traditional, Complementary, and Alternative Medicines. 2012;9(4):503-518.
7
Ehrlich, S. D. NMD, University of Maryland Medical Center, Complementary and Alternative Medicine Guide, Aromatherapy, http://umm.edu/health/medical/altmed/treatment/aromatherapy.
8
Prabuseenivasan, S., Jayakumar, M., & Ignacimuthu, S. (2006). In vitro antibacterial activity of some plant essential oils. BMC Complementary and Alternative Medicine, p. 6, 39.
9
Singh P, Chaturvedi A. Complementary and Alternative Medicine in Cancer Pain Management: A Systematic Review. Indian Journal of Palliative Care. 2015;21(1): p. 105-115. doi:10.4103/0973-1075.150202.
10
Suhail MM, Wu W, Cao A, et al. Boswellia sacra essential oil induces tumor cell-specific apoptosis and suppresses tumor aggressiveness in cultured human breast cancer cells. US National Library of Medicine National Institutes of Health BMC Complementary and Alternative Medicine. 2011;11:129. doi:10.1186/1472-6882-11-129.
11
Bayala B, Bassole IH, Scifo R, et al. Anticancer activity of essential oils and their chemical components - a review. American Journal of Cancer Research. 2014;4(6): p. 591-607.
12
Nordqvist, C., The Theory Behind Aromatherapy, Medical News Times, 2014, http://www.medicalnewstoday.com/articles/10884.php
13
Crow, D., Floracopeia, How to Use Essential Oils Effectively: A Comprehensive Overview, http://www.floracopeia.com/education/how-to-use-essential-oils-effectively/
14
National Institute of Health (NIH), National Cancer Institute, Aromatherapy and Essential Oils (PDQ®)–Health, https://www.cancer.gov/about-cancer/treatment/cam/hp/aromatherapypdq
15
Zu Y, Yu H, Liang L, Fu Y, Efferth T, Liu X, Wu N., Activities of ten essential oils towards Propionibacterium acnes and PC-3, A-549 and MCF-7 cancer cells. Molecules. 2010 Apr 30;15(5):3200-10. doi: 10.3390/molecules15053200
16
Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD. Use and Acceptance of Complementary and Alternative Medicine Among the General Population and Medical Personnel: A Systematic Review. The Ochsner Journal. 2012;12(1):45-56.
AROMATHERAPY AND BREAST CANCER
10
17
Frank MB, Yang Q, Osban J, Azzarello JT, Saban MR, Saban R, Ashley RA, Welter JC, Fung KM, Lin HK., Frankincense oil derived from Boswellia carteri induces tumor cell specific cytotoxicity. BMC Complement Altern Med. 2009 Mar 18;9:6. doi: 10.1186/1472-6882-9-6.
18
Park, Kyung-Ran et al., β-Caryophyllene oxide inhibits growth and induces apoptosis through the suppression of PI3K/AKT/mTOR/S6K1 pathways and ROS-mediated MAPKs activation, Cancer Letters, Volume 312, Issue 2 , 178 - 188
19
The Truth About Essential Oils and Cancer; http://drericz.com/the-truth-about-cancer-andessential-oils
20
Edens Garden, Pure Aromatherapy Guide: Single Oils, p. 7-35
21
How to Use Essential Oils While Undergoing Oncological Care http://essentialoilbenefits.com/how-to-use-essential-oils-while-undergoing-oncologicalcare/