Panacea Index Logo

Command Palette

Search for a command to run...

Massage with or without aromatherapy for symptom relief in people with cancer.

The Cochrane database of systematic reviews
January 1, 1970
Ein-Soon Shin et al. (7 authors)
Journal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effects of massage with or without aromatherapy (using essential oils) on pain and other symptoms in people with cancer.

Results Summary

The study found very low-quality evidence suggesting minor benefits of aromatherapy massage for pain, anxiety, and breast-related symptoms in cancer patients, but these effects were not clinically significant. No clear differences were observed between massage with aromatherapy and massage without aromatherapy.

Population

People with cancer of any age.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (15)
InterventionDirectionEndpointPopulationDosageImpactClaim #
massage
decrease
Short-term pain (Present Pain Intensity-Visual Analogue Scale)
people with cancer
mean difference (MD) -1.60, 95% confidence interval (CI) -2.67 to -0.53
was greater
#1
massage
no change
anxiety (State-Trait Anxiety Inventory-state)
people with cancer
combined MD -5.36, 95% CI -16.06 to 5.34
showed no significant difference
#2
massage
decrease
anxiety relief
children with cancer
MD -14.70, 95% CI -19.33 to -10.07
was greater
#3
massage
no change
depression
people with cancer
-
demonstrated no differences in effects
#4
massage
no change
mood disturbance
people with cancer
-
demonstrated no differences in effects
#5
massage
no change
psychological distress
people with cancer
-
demonstrated no differences in effects
#6
massage
no change
nausea
people with cancer
-
demonstrated no differences in effects
#7
massage
no change
fatigue
people with cancer
-
demonstrated no differences in effects
#8
massage
no change
physical symptom distress
people with cancer
-
demonstrated no differences in effects
#9
massage
no change
quality of life
people with cancer
-
demonstrated no differences in effects
#10
massage with aromatherapy
decrease
medium-term pain
people with cancer
MD 5.30, 95% CI 1.52 to 9.08
was greater
#11
massage with aromatherapy
decrease
long-term pain
people with cancer
MD 3.80, 95% CI 0.19 to 7.41
was greater
#12
massage with aromatherapy
decrease
anxiety
people with cancer
combined MD -4.50, 95% CI -7.70 to -1.30
was greater
#13
massage with aromatherapy
decrease
long-term symptoms relating to the breast
people with breast cancer
MD -9.80, 95% CI -19.13 to -0.47
was greater
#14
massage with aromatherapy
increase
medium-term quality of life score
people with cancer
MD -2.00, 95% CI -3.46 to -0.54
was lower (better)
#15
Abstract

BACKGROUND: Massage and aromatherapy massage are used to relieve cancer-related symptoms. A number of claims have been made for these treatments including reduction of pain, anxiety, depression, and stress. Other studies have not shown these benefits. OBJECTIVES: To evaluate the effects of massage with or without aromatherapy on pain and other symptoms associated with cancer. SEARCH METHODS: We searched the following databases and trials registries up to August 2015: the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 7), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), PubMed Cancer Subset, SADCCT, and the World Health Organization (WHO) ICTRP. We also searched clinical trial registries for ongoing studies. SELECTION CRITERIA: Randomised controlled studies (RCTs) reporting the effects of aromatherapy or massage therapy, or both, in people with cancer of any age. We applied no language restrictions. Comparators were massage (using carrier oil only) versus no massage, massage with aromatherapy (using carrier oil plus essential oils) versus no massage, and massage with aromatherapy (using carrier oil plus essential oils) versus massage without aromatherapy (using carrier oil only). DATA COLLECTION AND ANALYSIS: At least two review authors selected studies, assessed the risk of bias, and extracted data relating to pain and other symptoms associated with cancer, using standardised forms. We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and created two 'Summary of findings' tables. MAIN RESULTS: We included 19 studies (21 reports) of very low quality evidence with a total of 1274 participants. We included 14 studies (16 reports) in a qualitative synthesis and five studies in a quantitative synthesis (meta-analysis). Thirteen studies (14 reports, 596 participants) compared massage with no massage. Six studies (seven reports, 561 participants) compared aromatherapy massage with no massage. Two studies (117 participants) compared massage with aromatherapy and massage without aromatherapy. Fourteen studies had a high risk of bias related to sample size and 15 studies had a low risk of bias for blinding the outcome assessment. We judged the studies to be at unclear risk of bias overall. Our primary outcomes were pain and psychological symptoms. Two studies reported physical distress, rash, and general malaise as adverse events. The remaining 17 studies did not report adverse events. We downgraded the GRADE quality of evidence for all outcomes to very low because of observed imprecision, indirectness, imbalance between groups in many studies, and limitations of study design. Massage versus no-massage groupsWe analysed results for pain and anxiety but the quality of evidence was very low as most studies were small and considered at an unclear or high risk of bias due to poor reporting. Short-term pain (Present Pain Intensity-Visual Analogue Scale) was greater for the massage group compared with the no-massage group (one RCT, n = 72, mean difference (MD) -1.60, 95% confidence interval (CI) -2.67 to -0.53). Data for anxiety (State-Trait Anxiety Inventory-state) relief showed no significant difference in anxiety between the groups (three RCTs, n = 98, combined MD -5.36, 95% CI -16.06 to 5.34). The subgroup analysis for anxiety revealed that the anxiety relief for children was greater for the massage group compared with the no-massage group (one RCT, n = 30, MD -14.70, 95% CI -19.33 to -10.07), but the size of this effect was considered not clinically significant. Furthermore, this review demonstrated no differences in effects of massage on depression, mood disturbance, psychological distress, nausea, fatigue, physical symptom distress, or quality of life when compared with no massage. Massage with aromatherapy versus no-massage groupsWe analysed results for pain, anxiety, symptoms relating to the breast, and quality of life but the quality of evidence was very low as studies were generally at a high risk of bias. There was some indication of benefit in the aromatherapy-massage group but this benefit is unlikely to translate into clinical benefit. The relief of medium- and long-term pain (medium-term: one RCT, n = 86, MD 5.30, 95% CI 1.52 to 9.08; long-term: one RCT, n = 86, MD 3.80, 95% CI 0.19 to 7.41), anxiety (two RCTs, n = 253, combined MD -4.50, 95% CI -7.70 to -1.30), and long-term symptoms relating to the breast in people with breast cancer (one RCT, n = 86, MD -9.80, 95% CI -19.13 to -0.47) was greater for the aromatherapy-massage group, but the results were considered not clinically significant. The medium-term quality of life score was lower (better) for the aromatherapy-massage group compared with the no-massage group (one RCT, n = 30, MD -2.00, 95% CI -3.46 to -0.54). Massage with aromatherapy versus massage without aromatherapy groupsFrom the limited evidence available, we were unable to assess the effect of adding aromatherapy to massage on the relief of pain, psychological symptoms including anxiety and depression, physical symptom distress, or quality of life. AUTHORS' CONCLUSIONS: There was a lack of evidence on the clinical effectiveness of massage for symptom relief in people with cancer. Most studies were too small to be reliable and key outcomes were not reported. Any further studies of aromatherapy and massage will need to address these concerns.

Medical Subject Headings (MeSH)
AffectAnxietyAromatherapyBreast NeoplasmsDepressionFatigueFemaleHumansMaleMassageNeoplasmsPain ManagementPlant Oils
Study Links
Quality Scores
SafetyNot Assessed
Efficacy30/10
Quality45/10
Citation Metrics
Total Citations59
Citations/Year6.6
Relative Citation Ratio3.16
NIH Percentile86%
Research Impact Scores
APT Score0.95
Weight Score1.45
Normalized Score0.41
Related Supplements