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I don't like honey cake, which seems heresy to state right before Rosh Hashanah. After apples and round challah, honey cake is probably the most ubiquitous symbol of the New Year. Unfortunately it's right up there with the green- and red-speckled fruit cake as a food more about tradition than about flavor.
You've probably figured out where this is going. I challenged myself to make a honey cake that I could be proud of. I spent every evening last week making honey cakes. You can read all about my trials (and finally success!) in my most recent column in the Jerusalem Post. If you're in a rush, scroll down just a bit for the recipe and you'll bake yourself a cake that's really all about the honey. No nuts or fruits or coffee or alcohol. No fancy honey – plain old clover honey works great. You don't even need a stand mixer.
If you're still looking for a few good Rosh Hashana recipes, scroll down even further to a few dishes that I've made in years past. (And if your menu is set, please let me know what you're making. I'm going down to Atlanta again, and somehow I always volunteer, er get roped into, cooking something.)
And finally, a quick housekeeping note: I've added a new page entitled Published. Check it out to catch up on some of the articles I've written.
Caramelized honey cake
I developed this cake to celebrate honey for a sweet Rosh Hashanah. It's based on a Martha Stewart recipe that I made parve and adapted to better showcase the honey. I used soy milk, but almond milk should work well: use plain (not vanilla-flavored), full-fat milk alternative. Don't go for the non-fat versions (OK, that's a double negative – let me be more clear: USE THE FULL FAT VERSION). Before you bake the cake, drizzle the batter with extra honey which caramelizes in the oven, helping the cake develop a crispy edge. I've tested the recipe with and without a stand mixer and both work well – so go ahead and make this one by hand if you'd like.
Serves 8-10
– 2 eggs
– 1/4 C granulated sugar
– 1/2 C packed dark-brown sugar
– 1/2 C plain unsweetened soy milk (don't use vanilla flavor or non-fat; plain almond milk should work well too)
– 1/2 C vegetable oil, plus more for greasing the pan
– 1 C honey, divided
– 1 lemon for zest and juice (1 t zest, 1 T juice)
– 2 C all-purpose flour, plus more for dusting the pan
– 3/4 t baking powder
– 1/2 t baking soda
– 1 t kosher salt
– 1 t ground cinnamon
Prep. Preheat oven to 350˚F. Grease and flour a 10-inch springform or two 8X4-inch loaf pans.
Mix. In the bowl of a stand mixer, mix eggs and sugars on high speed with the paddle attachment until pale and thick, about 3 minutes. No mixer? Use a whisk and a little muscle – this will probably take 3-5 minutes depending on how strong you are! Add the soy milk, oil, 3/4 cup honey (reserve the remaining 1/4 cup for later), lemon zest, and lemon juice and keep mixing until everything is combined.
Fold. Sift the flour, baking powder, baking soda, salt, and cinnamon in a separate bowl (I use a fine mesh strainer to get out any lumps), and whisk together to mix. With a spatula, fold the dry ingredients into the wet in two batches until well mixed. Don't overwork the batter.
Fill. Fill the greased and floured pan(s) with the batter. Drizzle the remaining 1/4 cup (4 tablespoons) of honey over the batter, getting most of it around the edges.
Bake. Bake the cake – about 50 minutes for a round cake, 40 for two loaf pan until golden brown and a toothpick inserted into the center comes out clean. Try not to open the oven until almost the end of baking because this cake does have a tendency to fall a bit in the middle if you move it too much. You should be able to see through the door when the center is no longer jiggly – give it another few minutes and poke it with a toothpick. I tend to start looking (through the door!) about 10 minutes before time is up. When it comes out, the top should be slightly sticky because of the honey.
Cool. Let the cake cool in the pan on a wire rack for 15 minutes. Run a knife around the edge of the cake and carefully remove it from the pan.
Still planning your Rosh Hashanah menu? Here are a few things that I've made in the past that tie right into the New Year symbols and seasonal produce. Simanim, Hebrew for signs or omens, are the symbolic foods of Rosh Hashanah. A few years ago, my friend Sarah wrote up a great explanation of the simanim, many of which are based on word play – a great read!
Already know what you're going to make? Please share!
– Round challah– If you have a tried and true challah recipe, I've figured out how to weave it into a round loaf.
– Darna challah – If you need a challah recipe. This one is from Ayelet, a chef in Panama City.
– Bread machine challah – If you need a challah recipe and have a bread machine (though, I'm sure you figured out that one on your own).
– Arugula and pistachio salad with orange blossom dressing – A very simple salad, though some people don't eat nuts on Rosh Hashanah (they're believed to represent sins).
– Spicy butternut squash soup – Squash is a siman (singular of simanim). I wrote about this soup here and my wish for a spicy new year.
– Squash mash with balsamic onions – Yup, squash again.
– Pomegranate roasted carrots – Two simanim in one here – pomegranate and carrots. Pomegranate molasses (pomegranate syrup) is one of my favorite ingredients these days. It's sticky, tart, and slightly sweet and perfect for the New Year.
– Two more recipes with pomegranate molasses, this time meat: Ana Sortun's spoon lamb and then my adaptation of the recipe for French roast or brisket.
– Roast a chicken, using either the classic flavors of lemon and thyme or something more creative – maybe apple and cinnamon or roast atop a pile of leeks (siman).
– Fish is another siman. Here are recipes for sea bass and two salmon dishes; the techniques can be applied to other fishes as well.
– Honey cake (see above)
– Easy apple cake – A one bowl, one pan apple cake. No stand mixer necessary. Oh, and truly fabulous.
– Apfelstrudel with cinnamon caramel – Apple strudel, using store bought puff pastry. A German classic. Leave out the pecans if you don't eat nuts on Rosh Hashanah.
– Tarte Tatin aux Poires et Vin – Upside-down pear tart with red wine caramel. If you're feeling fancy.
– Plums are finishing up their season – try any of the three plum cakes I've made over the past few weeks.
I wish you all שנה טובה ומתוקה, shana tova u'metukah, a wonderfully sweet year filled with fun, adventure, and good food! See you in 5773.


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About Author
Matt Mullens is a founder of bestdesign2themes as well as a web developer. He loves writing about best web design and also sharing knowledge about latest advancements in the world of Web design and development. He also likes to share ideas about cms, various software, Programming languages and technology.


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Here is another class picture of my Aunt Jackie. As the sign tells, this picture is from Southwest School in Burley, Cassia, Idaho taken in March 1971. The names were written on a piece of paper inside. If they are incorrect, please let me know. I would be happy to update the information.
Bret Sever
Steven McDaniels
Becky Kolman
Kim Maier
Gina Richardson
Leslie Easton
Keith Barns
Jeff Holland
Rodney Hansen
Mrs. Matthews
Steven Devers
John Matthews
Trudy Mills
Rachell Harris
Lisa Thompson
Jenny Ford
Toye Kopkins
David Lynn
Val Paterson
Mark Bonner
Greg Morten
Katherine Ringell
Debbie Hatt
Wendy Muir
Cory Parish
Robert Miller
Jackie Jonas
Mike Larson
Kathy Larson
Douglas Brown


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About 20 people stood in a rain-snow mix and cold temperatures Saturday morning above Vallecito Reservoir to call on Mark Redwine to be more active in the search for his son, Dylan, who has been missing since just before Thanksgiving.
Dylan Redwine, 13, was reported missing from his fathers home on County Road 500 on Nov. 19. The boy had arrived the night before from his home north of Colorado Springs for a court-ordered visit.
In a telephone interview Saturday, Mark Redwine took exception to the portrayal of him as disengaged from the search for his youngest son.
I do a lot of things on my own, said Redwine, a truck driver. Among his other activities, every time I get (back) into Durango, I talk to other truck drivers to have them keep fliers in their rigs, he said.
Thats counter to what is being alleged by Dylans mother, Elaine, and people like Bayfield resident, businesswoman and Redwine family friend Denise Hess. Hess has helped lead the public effort to find Dylan.
Hess said Saturday morning that the demonstrators, were hoping (Mark Redwine) will come out and participate.
Hess claimed that Mark Redwine has been much less involved in the various public activities than have Elaine and Dylans older brother, Cory, not to mention law enforcement and the general public.
Yet Mark Redwine said his ex-wife and Hess actually have left him out of a number of events, sometimes not giving him enough notice to attend.
Its bizarre to me why Elaine and Denise would leave me out, he said.
Redwine also claimed he was contacted by a woman who wanted to do a raffle to raise money for the Dylan Redwine reward fund, now $50,450, but Elaine Redwine and Hess turned down the offer.
Im just as much affected by this as these two, he said.
Redwine said that law enforcement even suggested that the Redwines, divorced six years ago, get mediation so they can work together better to find Dylan. So far, he said, Elaine has not accepted.
Redwine said his ex-wife has contacted him using text messages.
Ive responded to every text message shes sent me, but she wont pick up the phone ... and talk to me, he said.
The other reason for Saturdays walk was to keep the search for Dylan in the news.
I hate public speaking, and I hate cameras, Hess said, but I want to bring Dylan home, a sentiment echoed by Cory Redwine, who also participated Saturday.
Were just trying to keep his face out there and just never let it die down until he comes home, Cory Redwine, 21, said.
Several members of the group, who stood on the east side of the road across from Mark Redwines house, held handwritten signs directed at him.
Why do you hide, read one of the signs. Another read: No walk! All talk! We all miss you Dylan.
The walkers included Kathi Barry, a political blogger from Evergreen. She saw the notice about a missing boy less than two months after the abduction and murder of 10-year-old Jessica Ridgeway. Jessica was kidnapped on her way to school Oct. 5. Her dismembered body was found five days later in a field in Arvada.
Barry said she was bothered by Dylans disappearance and eventually decided she needed to come to the Western Slope to help. She has been to the area on weekends, has come to be close friends with Hess and gotten to know Elaine Redwine.
Of the latter, she said, Every time I look at her, I cry because I can see the pain in her face.
But Mark Redwine said he couldnt understand Barrys motivation for being so negative toward him, saying that she argues with anyone who doesnt agree with her positions about what may have happened to Dylan.
Jenna How of Durango said she has been following this from Day 1. They ran out of fliers during the first week, so I started printing for them. How works for Xerox and has access to a printer.
She said her goal Saturday was to bring more attention to Dylan, find out answers, bring him home.
Cory Redwine said that he and his mother know just about as much now as they did at the beginning of the ordeal.
He said law enforcement has searched Mark Redwines house and have gotten clues along the way, but so far, they have not revealed anything significant to the family.
The La Plata County Sheriffs Office and the FBI met recently to review strategies as well as results from forensic tests by the Colorado Bureau of Investigation, according to a news release from sheriffs spokesman Lt. Dan Bender. No details were released.
Cory Redwine said his mother is hanging in there and staying tough, but she is having as hard of a time as anybody, but shes ... stronger than most. Im proud to be her son.
He also said his relationship with Mark Redwine has been rocky, but he believes Mark has some answers.
When asked why Mark was not helping as much as people think he should, Cory Redwine said, I think he has a part in this. Im not sure exactly to what extent, but if your sons really missing, most people would be doing anything they could to bring him home, not avoid the situation.
Cory said that Mark Redwine usually is not reluctant to be out front.
If he thinks hes right, hell do everything he can to be out front. He doesnt back down when hes in the right, Cory Redwine said. Hes laid low and hasnt really done a whole lot.
The senior Redwine said there is a history with Cory, but he said he thinks his sons anger toward him is reflective of his mothers hatred toward Mark.
Despite that remark, Redwine said, I dont fault her for finding someone to blame.
Redwine also said that all the online speculation wasnt helping the situation.
There are too many people sitting at the computer trying to play Nancy Drew and Nancy Grace, he said. Its not bringing us closer to finding Dylan.


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National Cancer Institute
Post Date: Feb 7, 2018
Aromatherapy with the use of essential oils has been studied in cancer patients to help with symptom relief. Read about how aromatherapy massage or inhalation of essential oils have reduced symptoms in cancer patients in this expert-reviewed summary.
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of aromatherapy and essential oils in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
This summary is reviewed regularly and updated as necessary by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Aromatherapy and Essential Oils
This cancer information summary provides an overview of the use of aromatherapy and essential oils primarily to improve the quality of life of cancer patients. This summary includes a brief history of aromatherapy, a review of laboratory studies and clinical trials, and possible adverse effects associated with aromatherapy use.
This summary contains the following key information:
- Aromatherapy is the therapeutic use of essential oils (also known as volatile oils) from plants (flowers, herbs, or trees) for the improvement of physical, emotional, and spiritual well-being.
- Aromatherapy is used by patients with cancer primarily as supportive care for general well-being.
- Aromatherapy is used with other complementary treatments (e.g., massage and acupuncture) as well as with standard treatments for symptom management.
- Essential oils are volatile liquid substances extracted from aromatic plant material by steam distillation or mechanical expression; oils produced with the aid of chemical solvents are not considered true essential oils.
- Essential oils are available in the United States for inhalation and topical treatment. Topical treatments are generally used in diluted forms.
- Aromatherapy is not widely administered via ingestion.
- The effects of aromatherapy are theorized to result from the binding of chemical components in the essential oil to receptors in the olfactory bulb, impacting the brain's emotional center, the limbic system. Topical application of aromatic oils may exert antibacterial, anti-inflammatory, and analgesic effects.
- Studies in animals show sedative and stimulant effects of specific essential oils as well as positive effects on behavior and the immune system. Functional imaging studies in humans support the influence of odors on the limbic system and its emotional pathways.
- Human clinical trials have investigated aromatherapy primarily in the treatment of stress and anxiety in patients with critical illnesses or in other hospitalized patients. Several clinical trials involving patients with cancer have been published.
- Aromatherapy has a relatively low toxicity profile when administered by inhalation or diluted topical application.
- Aromatherapy products are not subject to approval by the U.S. Food and Drug Administration unless there is a claim for treatment of specific diseases.
Many of the medical and scientific terms used in the summary are hypertext linked (at first use in each section) to the NCI Dictionary of Cancer Terms, which is oriented toward nonexperts. When a linked term is clicked, a definition will appear in a separate window.
Reference citations in some PDQ cancer information summaries may include links to external websites that are operated by individuals or organizations for the purpose of marketing or advocating the use of specific treatments or products. These reference citations are included for informational purposes only. Their inclusion should not be viewed as an endorsement of the content of the websites, or of any treatment or product, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board or the National Cancer Institute.
General Information
Aromatherapy is a derivative of herbal medicine, which is itself a subset of the biological or nature-based complementary and alternative medicine (CAM) therapies. Aromatherapy has been defined as the therapeutic use of essential oils from plants for the improvement of physical, emotional, and spiritual well-being.
Essential oils are volatile liquid substances extracted from aromatic plant material by steam distillation or mechanical expression. Essential oils produced with the aid of chemical solvents are not considered true essential oils, because the solvent residues can alter the quality of the essential oils and lead to adulteration of the fragrance or to skin irritation.
Essential oils are made up of a large array of chemical components that consist of the metabolites found in various plant materials. The major chemical components of essential oils include monoterpenes, esters, aldehydes, ketones, alcohols, phenols, and oxides, which are volatile and may produce characteristic odors. Different types of essential oils contain varying amounts of each of these compounds, which are said to give each essential oil its particular fragrance and therapeutic characteristics. Plant species may have different chemovarieties (variations of subspecies that produce essential oils with different chemical compositions, as a result of genetic variation and growth conditions). Thus, their essential oils can occur as several chemotypes that differ in chemical composition and may produce different clinical effects. It should be noted that essential oils are distinctly different chemically from (fatty) oils, such as those used as food.
Synthetic odors are often made up of many of the same compounds that are components of the essential oils. These compounds are synthesized and typically combined with other odor-producing chemicals. However, synthetic fragrances frequently contain irritants, such as solvents and propellants, that can trigger sensitivities in some people. Most aromatherapists believe that synthetic fragrances are inferior to essential oils because they lack natural or vital energy; however, this has been contested by odor psychologists and biochemists.
Aromatherapy is used or claimed to be useful for a vast array of symptoms and conditions. A book on aromatherapy in children suggests aromatherapy remedies for everything from acne to whooping cough. Published studies regarding the uses of aromatherapy have generally focused on its psychological effects (used as a stress reliever or anxiolytic agent) or its use as a topical treatment for skin-related conditions.
A large body of literature has been published on the effects of odors on the human brain and emotions. Some studies have tested the effects of essential oils on mood, alertness, and mental stress in healthy subjects. Other studies investigated the effects of various (usually synthetic) odors on task performance, reaction time, and autonomic parameters or evaluated the direct effects of odors on the brain via electroencephalogram patterns and functional imaging studies. Such studies have consistently shown that odors can produce specific effects on human neuropsychological and autonomic function and that odors can influence mood, perceived health, and arousal. These studies suggest that odors may have therapeutic applications in the context of stressful and adverse psychological conditions.
Practitioners of aromatherapy apply essential oils using several different methods, including (1) indirect inhalation via a room diffuser or drops of oil placed near the patient (e.g., on a tissue), or inside a vial with saturated cotton,(2) direct inhalation used in an individual inhaler (e.g., a few drops of essential oil floated on top of hot water to aid a sinus headache), or (3) aromatherapy massage, which is the application to the body of essential oils diluted in a carrier oil. Other direct and indirect applications include mixing essential oils in bath salts and lotions or applying them to dressings.
Different aromatherapy practitioners may have different recipes for treating specific conditions, involving various combinations of essential oils and methods of application. Differences seem to be practitioner dependent, with some common uses more accepted throughout the aromatherapy community. Training and certification in aromatherapy for lay practitioners is available at several schools throughout the United States and United Kingdom; however, there is no professional standardization in the United States and no license is required to practice in either country. Thus, there is little consistency among practitioners in the specific treatments used for specific illnesses. This lack of standardization has led to variability in therapeutic protocols used in research on the effects of aromatherapy. Anecdotal evidence alone or previous experience has driven the choice of essential oils and different researchers choose different essential oils when studying the same applications. However, now there are specific courses for licensed health professionals that give nursing or continuing medical education credit hours, including a small research component and information about evaluating and measuring outcomes.
The National Association for Holistic Aromatherapy (NAHA) (www.naha.org/) and the Alliance of International Aromatherapists (www.alliance-aromatherapists.org) are the two governing bodies for national educational standards for aromatherapists. NAHA is taking steps toward standardizing aromatherapy certification in the United States. Many schools offer certificate programs approved by NAHA. A list of these schools can be found on the NAHA website (https://www.naha.org/education/approved-schools/). National examinations in aromatherapy are held twice per year.
The Canadian Federation of Aromatherapists has established standards for aromatherapy certification in Canada (www.cfacanada.com/). They also have standards for safety and professional conduct and a public directory of certified aromatherapists. Other countries may have similar organizations.
Although essential oils are given orally or internally by aromatherapists in France and Germany, use is generally limited to inhalation or topical application in the United Kingdom and United States. Nonmedical use of essential oils is common in the flavoring and fragrance industries. Most essential oils have been classified as GRAS (generally recognized as safe), at specified concentration limits, by the U.S. Food and Drug Administration (FDA). (Refer to the International Federation of Aromatherapists website [www.ifaroma.org/] for a list of international aromatherapy programs.)
Aromatherapy products do not need approval by the FDA.
- Wildwood C: The Encyclopedia of Aromatherapy. Rochester, Vt: Healing Arts Press, 1996.
- Silva-Néto RP, Peres MF, Valença MM: Odorant substances that trigger headaches in migraine patients. Cephalalgia 34 (1): 14-21, 2014.
- Vethanayagam D, Vliagoftis H, Mah D, et al.: Fragrance materials in asthma: a pilot study using a surrogate aerosol product. J Asthma 50 (9): 975-82, 2013.
- Celeiro M, Guerra E, Lamas JP, et al.: Development of a multianalyte method based on micro-matrix-solid-phase dispersion for the analysis of fragrance allergens and preservatives in personal care products. J Chromatogr A 1344: 1-14, 2014.
- Dodd GH: The molecular dimension in perfumery. In: Van Toller S, Dodd GH, eds.: Perfumery: The Psychology and Biology of Fragrance. New York, NY: Chapman and Hall, 1988, pp 19-46.
- Worwood VA: Aromatherapy for the Healthy Child: More Than 300 Natural, Non-Toxic, and Fragrant Essential Oil Blends. Novato, Calif: New World Library, 2000.
- Buchbauer G, Jirovetz L, Jäger W, et al.: Fragrance compounds and essential oils with sedative effects upon inhalation. J Pharm Sci 82 (6): 660-4, 1993.
Proponents of aromatherapy report that aromatic or essential oils have been used for thousands of years as stimulants or sedatives of the nervous system and as treatments for a wide range of other disorders. They link it historically to the use of infused oils and unguents in the Bible and ancient Egypt, remedies used throughout the Middle Ages and the Renaissance, and the burning of aromatic plants in various religious rites. The current applications of aromatherapy did not come about until the early 20th century when the French chemist and perfumer Rene Gattefosse coined the term aromatherapy and published a book of that name in 1937. Gattefosse proposed the use of aromatherapy to treat diseases in virtually every organ system, citing mostly anecdotal and case-based evidence.
Although Gattefosse and his colleagues in France, Italy, and Germany studied the effects of aromatherapy for some 30 years, its use went out of fashion midcentury and was rediscovered by another Frenchman, a physician, Jean Valnet, in the latter part of the century. Valnet published his book The Practice of Aromatherapy in 1982, at which time the practice became more well-known in Britain and the United States. Through the 1980s and 1990s, as patients in Western countries became increasingly interested in complementary and alternative medicine (CAM) treatments, aromatherapy developed a following that continues to grow to this day. In addition to the use of essential oils by nurses and aromatherapy practitioners for specific medical issues, the popularity of aromatherapy has also been exploited by cosmetics companies that have created lines of essential oil-based (although often with a synthetic component) cosmetics and toiletries, claiming to improve mood and well-being in their users.
Despite the growing popularity of aromatherapy in the latter part of the 20th century (especially in the United Kingdom), little research on aromatherapy was available in the English-language medical literature until the early or mid-1990s. The research that began to appear in the 1990s was most often conducted by nurses, who tended to be the primary practitioners of aromatherapy in the United States and United Kingdom (although it is dispensed by medical doctors in France and Germany). Aromatherapists now publish their own journal, the International Journal of Essential Oil Therapeutics. Also, many studies regarding the effects of odor on the brain and other systems in animals and healthy humans have been published in the context of odor psychology and neurobiology (and in the absence of the specific term aromatherapy).
In addition to topical antimicrobial uses, aromatherapy has also been proposed for use in wound care and to treat a variety of localized symptoms and illnesses such as alopecia, eczema, and pruritus. Aromatherapy has also been studied via inhalation for airway reactivity.
Studies on aromatherapy have examined a variety of other conditions: sedation and arousal; startle reflex and reaction time; psychological states such as mood, anxiety, and general sense of well-being; psychiatric disorders; neurologic impairment; chronic renal failure; agitation in patients with dementia; smoking withdrawal symptoms; motion sickness; postoperative nausea; nausea and emesis in combination with fatigue, pain, and anxiety in patients in labor; pain alone; and pain in combination with other symptoms.
Published articles have described the use of aromatherapy in specific hospital settings such as cancer wards, hospices, and other areas where patients are critically ill and require palliative care for pain, nausea, lymphedema, generalized stress, anxiety, and depression. These observational studies provide examples of the clinical uses of aromatherapy (and other CAM modalities), although they are generally not evidence based. Subjects have included hospitalized children with HIV, homebound patients with terminal disease, and hospitalized patients with leukemia. Aromatherapy has also been used to reduce malodor of necrotic ulcers in cancer patients.
Studies of aromatherapy use with mental health patients have also been conducted. Most of the resulting articles describe successful incorporation of aromatherapy into the treatment of these patients, although outcomes are clearly subjective.
Theories about the mechanism of action of aromatherapy and essential oils differ, depending on the community studying them. Proponents of aromatherapy often cite the connection between olfaction and the limbic system in the brain as the basis for the effects of aromatherapy on mood and emotions; less is said about proposed mechanisms for its effects on other parts of the body. Most of the aromatherapy literature, however, lacks in-depth neurophysiological studies on the nature of olfaction and its link to the limbic system, and it generally does not cite research that shows these links. Proponents of aromatherapy also believe that the effects of the treatments are based on the special nature of the essential oils used and that essential oils produce effects on the body that are greater than the sum of the individual chemical components of the scents.
These assertions have been contested by the biochemistry and psychology communities, which take a different view of the possible mechanism of action of odors on the human brain (most do not differentiate the odors produced by essential oils from those of synthetic fragrances). This neurobiological view, which focuses mostly on the emotional and psychological effects of fragrances (as opposed to the other symptomatic effects claimed by aromatherapists), takes into account what is known about olfactory transduction and the connection of the olfactory system to other central nervous system functions, including memory; however, it is primarily theoretical because of the lack of significant research addressing this topic.
- Tisserand R: Essential oils as psychotherapeutic agents. In: Van Toller S, Dodd GH, eds.: Perfumery: The Psychology and Biology of Fragrance. New York, NY: Chapman and Hall, 1988, pp 167-80.
- Gattefosse RM: Gattefosse's Aromatherapy. Essex, England:CW Daniel, 1993.
- Valnet J: The Practice of Aromatherapy: A Classic Compendium of Plant Medicines & Their Healing Properties. Rochester, NY: Healing Arts Press, 1990.
- Hartman D, Coetzee JC: Two US practitioners' experience of using essential oils for wound care. J Wound Care 11 (8): 317-20, 2002.
- Asquith S: The use of aromatherapy in wound care. J Wound Care 8 (6): 318-20, 1999.
- Edwards-Jones V, Buck R, Shawcross SG, et al.: The effect of essential oils on methicillin-resistant Staphylococcus aureus using a dressing model. Burns 30 (8): 772-7, 2004.
- Hay IC, Jamieson M, Ormerod AD: Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol 134 (11): 1349-52, 1998.
- Anderson C, Lis-Balchin M, Kirk-Smith M: Evaluation of massage with essential oils on childhood atopic eczema. Phytother Res 14 (6): 452-6, 2000.
- Ro YJ, Ha HC, Kim CG, et al.: The effects of aromatherapy on pruritus in patients undergoing hemodialysis. Dermatol Nurs 14 (4): 231-4, 237-8, 256; quiz 239, 2002.
- Cohen BM, Dressler WE: Acute aromatics inhalation modifies the airways. Effects of the common cold. Respiration 43 (4): 285-93, 1982.
- Diego MA, Jones NA, Field T, et al.: Aromatherapy positively affects mood, EEG patterns of alertness and math computations. Int J Neurosci 96 (3-4): 217-24, 1998.
- Motomura N, Sakurai A, Yotsuya Y: Reduction of mental stress with lavender odorant. Percept Mot Skills 93 (3): 713-8, 2001.
- Miltner W, Matjak M, Braun C, et al.: Emotional qualities of odors and their influence on the startle reflex in humans. Psychophysiology 31 (1): 107-10, 1994.
- Millot JL, Brand G, Morand N: Effects of ambient odors on reaction time in humans. Neurosci Lett 322 (2): 79-82, 2002.
- Stevenson C: Measuring the effects of aromatherapy. Nurs Times 88 (41): 62-3, 1992 Oct 7-13.
- Dunn C, Sleep J, Collett D: Sensing an improvement: an experimental study to evaluate the use of aromatherapy, massage and periods of rest in an intensive care unit. J Adv Nurs 21 (1): 34-40, 1995.
- Buckle J: Aromatherapy. Nurs Times 89 (20): 32-5, 1993 May 19-25.
- 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.
- Wilkinson S: Aromatherapy and massage in palliative care. Int J Palliat Nurs 1 (1): 21-30, 1995.
- Wilkinson S, Aldridge J, Salmon I, et al.: An evaluation of aromatherapy massage in palliative care. Palliat Med 13 (5): 409-17, 1999.
- 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.
- Louis M, Kowalski SD: Use of aromatherapy with hospice patients to decrease pain, anxiety, and depression and to promote an increased sense of well-being. Am J Hosp Palliat Care 19 (6): 381-6, 2002 Nov-Dec.
- Walsh E, Wilson C: Complementary therapies in long-stay neurology in-patient settings. Nurs Stand 13 (32): 32-5, 1999 Apr 28-May 4.
- Itai T, Amayasu H, Kuribayashi M, et al.: Psychological effects of aromatherapy on chronic hemodialysis patients. Psychiatry Clin Neurosci 54 (4): 393-7, 2000.
- Burns E, Blamey C: Complementary medicine. Using aromatherapy in childbirth. Nurs Times 90 (9): 54-60, 1994 Mar 2-8.
- Burns EE, Blamey C, Ersser SJ, et al.: An investigation into the use of aromatherapy in intrapartum midwifery practice. J Altern Complement Med 6 (2): 141-7, 2000.
- Kite SM, Maher EJ, Anderson K, et al.: Development of an aromatherapy service at a Cancer Centre. Palliat Med 12 (3): 171-80, 1998.
- Komori T, Fujiwara R, Tanida M, et al.: Effects of citrus fragrance on immune function and depressive states. Neuroimmunomodulation 2 (3): 174-80, 1995 May-Jun.
- Wiebe E: A randomized trial of aromatherapy to reduce anxiety before abortion. Eff Clin Pract 3 (4): 166-9, 2000 Jul-Aug.
- Perry N, Perry E: Aromatherapy in the management of psychiatric disorders: clinical and neuropharmacological perspectives. CNS Drugs 20 (4): 257-80, 2006.
- Ballard CG, O'Brien JT, Reichelt K, et al.: Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo-controlled trial with Melissa. J Clin Psychiatry 63 (7): 553-8, 2002.
- Smallwood J, Brown R, Coulter F, et al.: Aromatherapy and behaviour disturbances in dementia: a randomized controlled trial. Int J Geriatr Psychiatry 16 (10): 1010-3, 2001.
- Holmes C, Hopkins V, Hensford C, et al.: Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry 17 (4): 305-8, 2002.
- Gray SG, Clair AA: Influence of aromatherapy on medication administration to residential-care residents with dementia and behavioral challenges. Am J Alzheimers Dis Other Demen 17 (3): 169-74, 2002 May-Jun.
- Snow LA, Hovanec L, Brandt J: A controlled trial of aromatherapy for agitation in nursing home patients with dementia. J Altern Complement Med 10 (3): 431-7, 2004.
- Rose JE, Behm FM: Inhalation of vapor from black pepper extract reduces smoking withdrawal symptoms. Drug Alcohol Depend 34 (3): 225-9, 1994.
- Sayette MA, Parrott DJ: Effects of olfactory stimuli on urge reduction in smokers. Exp Clin Psychopharmacol 7 (2): 151-9, 1999.
- Post-White N, Nichols W: Randomized trial testing of QueaseEase™ essential oil for motion sickness. International Journal of Essential Oil Therapeutics 1 (4): 158-66, 2007.
- Tate S: Peppermint oil: a treatment for postoperative nausea. J Adv Nurs 26 (3): 543-9, 1997.
- Hines S, Steels E, Chang A, et al.: Aromatherapy for treatment of postoperative nausea and vomiting. Cochrane Database Syst Rev 4: CD007598, 2012.
- Oyama H, Kaneda M, Katsumata N, et al.: Using the bedside wellness system during chemotherapy decreases fatigue and emesis in cancer patients. J Med Syst 24 (3): 173-82, 2000.
- Dale A, Cornwell S: The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomized clinical trial. J Adv Nurs 19 (1): 89-96, 1994.
- Göbel H, Schmidt G, Soyka D: Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters. Cephalalgia 14 (3): 228-34; discussion 182, 1994.
- Marchand S, Arsenault P: Odors modulate pain perception: a gender-specific effect. Physiol Behav 76 (2): 251-6, 2002.
- Kim JT, Wajda M, Cuff G, et al.: Evaluation of aromatherapy in treating postoperative pain: pilot study. Pain Pract 6 (4): 273-7, 2006.
- Barclay J, Vestey J, Lambert A, et al.: Reducing the symptoms of lymphoedema: is there a role for aromatherapy? Eur J Oncol Nurs 10 (2): 140-9, 2006.
- Kohara H, Miyauchi T, Suehiro Y, et al.: Combined modality treatment of aromatherapy, footsoak, and reflexology relieves fatigue in patients with cancer. J Palliat Med 7 (6): 791-6, 2004.
- Buckle J: Clinical Aromatherapy: Essential Oils in Practice. 2nd ed. New York, NY: Churchill Livingston, 2003.
- Wilkinson SM, Love SB, Westcombe AM, et al.: Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. J Clin Oncol 25 (5): 532-9, 2007.
- Styles JL: The use of aromatherapy in hospitalized children with HIV disease. Complement Ther Nurs Midwifery 3 (1): 16-20, 1997.
- Rimmer L: The clinical use of aromatherapy in the reduction of stress. Home Healthc Nurse 16 (2): 123-6, 1998.
- Stringer J: Massage and aromatherapy on a leukaemia unit. Complement Ther Nurs Midwifery 6 (2): 72-6, 2000.
- Warnke PH, Sherry E, Russo PA, et al.: Antibacterial essential oils in malodorous cancer patients: clinical observations in 30 patients. Phytomedicine 13 (7): 463-7, 2006.
- Hicks G: Aromatherapy as an adjunct to care in a mental health day hospital. J Psychiatr Ment Health Nurs 5 (4): 317, 1998.
Laboratory/Animal/Preclinical Studies
Numerous studies on the topical antibacterialeffects of essential oils have been published; most have found the essential oils to have significant antimicrobial activity. Some essential oils are antiviral and inhibit replication of the herpes simplex virus. Other essential oils are fungistatic and fungicidal against both vaginal and oropharyngeal Candida albicans.
Studies on rats in Europe and Japan have shown that exposure to various odors can result in stimulation or sedation, as well as changes in behavioral responses to stress and pain. A study on the sedative effects of essential oils and other fragrance compounds (mostly individual chemical components of the essential oils) on rat motility showed that lavender oil (Lavandula angustifolia Miller [synonyms: Lavandula spicata L.; Lavandula vera DC.]) in particular had a significant sedative effect, and several single-oil constituents (as opposed to whole essential oils) had similarly strong effects. The authors do not comment on the presumed mechanism for this effect, although they suggest that the difference in results between the different essential oils (some of which were found to be stimulating, some sedative) is related to the "different chemical structures of the compounds…and functional groups…indicating the essential role of the volatility of the fragrance compounds and its bioavailability." The differences in bioavailability are ascribed to different levels of lipophilia, with the more lipophilic oils producing the most sedative effects. The researchers also found significant plasma levels of the fragrance compounds after inhalation, suggesting that the effects of aromatherapy result from a direct pharmacological interaction rather than an indirect central nervous system relay.
Other studies have investigated the effects of aromatherapy on rats' behavioral and immunological responses to painful, stressful, or startling stimuli. In two European studies, rats exposed to pleasant odors during painful stimuli exhibited decreased pain-related behaviors, with some variation in response between the sexes. Two studies from Japan showed an improvement in immunological and behavioral markers in rats exposed to fragrances while under stressful conditions.
- Aridoğan BC, Baydar H, Kaya S, et al.: Antimicrobial activity and chemical composition of some essential oils. Arch Pharm Res 25 (6): 860-4, 2002.
- Minami M, Kita M, Nakaya T, et al.: The inhibitory effect of essential oils on herpes simplex virus type-1 replication in vitro. Microbiol Immunol 47 (9): 681-4, 2003.
- D'Auria FD, Tecca M, Strippoli V, et al.: Antifungal activity of Lavandula angustifolia essential oil against Candida albicans yeast and mycelial form. Med Mycol 43 (5): 391-6, 2005.
- Buchbauer G, Jirovetz L, Jäger W, et al.: Fragrance compounds and essential oils with sedative effects upon inhalation. J Pharm Sci 82 (6): 660-4, 1993.
- Aloisi AM, Ceccarelli I, Masi F, et al.: Effects of the essential oil from citrus lemon in male and female rats exposed to a persistent painful stimulation. Behav Brain Res 136 (1): 127-35, 2002.
- Jahangeer AC, Mellier D, Caston J: Influence of olfactory stimulation on nociceptive behavior in mice. Physiol Behav 62 (2): 359-66, 1997.
- Shibata H, Fujiwara R, Iwamoto M, et al.: Immunological and behavioral effects of fragrance in mice. Int J Neurosci 57 (1-2): 151-9, 1991.
- Fujiwara R, Komori T, Noda Y, et al.: Effects of a long-term inhalation of fragrances on the stress-induced immunosuppression in mice. Neuroimmunomodulation 5 (6): 318-22, 1998 Nov-Dec.
Human/Clinical Studies
No studies in the published peer-reviewed literature discuss aromatherapy as a treatment for cancer specifically. The studies discussed below, most of which were conducted in patients with cancer, primarily focus on other health-related conditions and on quality-of-life measures such as stress and anxiety levels.
A major review published in 2000 focused on six studies investigating treatment or prevention of anxiety with aromatherapy massage. Although the studies suggested that aromatherapy massage had a mild transient anxiolytic effect, the authors concluded that the research done at that time was not sufficiently rigorous or consistent to prove the effectiveness of aromatherapy in treating anxiety. This review excluded trials related to other effects of aromatherapy (such as pain control) and did not include any studies looking at the effects of odors that were not specifically labeled as aromatherapy.
Several of the studies included in the Cochrane Database of Systematic Reviews are discussed in more detail. A randomized controlled pilot study examined the effects of adjunctive aromatherapy massage on mood, quality of life, and physical symptoms in patients with cancer. Forty-six patients were randomly assigned to conventional day care alone or day care plus weekly aromatherapy massage using a standardized blend of essential oils (1% lavender and chamomile in sweet almond carrier oil) for 4 weeks. Patients self-rated their mood, quality of life, and the intensity of the two symptoms that were the most concerning to them at the beginning of the study and at weekly intervals thereafter. Of the 46 patients, only 11 of 23 (48%) in the aromatherapy group and 18 of 23 (78%) in the control group completed all of the 4 weeks. Patient-reported mood, symptoms, and quality of life improved in both groups, and there was no statistically significant difference between the two groups in any of these measures.
Another randomized controlled trial examined the effects of aromatherapy massage and massage alone on 42 patients with advanced cancer over a 4-week period. Patients were randomly assigned to receive weekly massages with or without aromatherapy; the treatment group (aromatherapy group) received massages with lavender essential oil (Lavandula angustifolia Miller [synonyms: Lavandula spicata L.; Lavandula vera DC.]) and an inert carrier oil, and the control group (massage group) received either an inert carrier oil alone or no intervention. The authors reported no significant long-term benefits of aromatherapy or massage in pain control, quality of life, or anxiety, but sleep scores (as measured by the Verran and Snyder-Halpern sleep scale) improved significantly in both groups. The authors also reported statistically significant reductions in depression scores (as measured by the Hospital Anxiety and Depression Scale [HADS]) in the massage-only group.
A placebo-controlled, double-blind, randomized trial conducted in Australia investigated the effects of inhalation aromatherapy on anxiety during radiation therapy. A total of 313 patients receiving radiation therapy were randomly assigned to one of three groups: carrier oil with fractionated essential oils, carrier oil only, or pure essential oils of lavender, bergamot (Citrus aurantium L. ssp. bergamia [Risso] Wright & Arn. [Rutaceae]; [synonym: Citrus bergamia Risso]), and cedarwood (Cedrus atlantica [Endl.] Manetti ex Carriere [Pinaceae]). All three groups received the oils by inhalation during their radiation therapy. The authors reported no significant differences in depression (as measured by HADS) or psychological effects (as measured by the Somatic and Psychological Health Report) between the groups. The group that received only the carrier oil showed a statistically significant decrease in anxiety (as measured by HADS) compared with the other two groups.
Another randomized controlled trial investigated the effects of massage or aromatherapy massage in 103 cancer patients who were randomly assigned to receive massage using a carrier oil (massage group) or massage using a carrier oil plus the Roman chamomile essential oil (Chamaemelum nobile [L.] All. [synonym: Anthemis nobilis L.]) (aromatherapy massage group). Two weeks after the massage, the authors found a statistically significant reduction in anxiety in the aromatherapy massage group (as measured by the State-Trait Anxiety Inventory) and an improvement in symptoms (as measured by the Rotterdam Symptom Checklist [RSCL]; the subscales with improved scores were psychological, quality of life, severe physical, and severe psychological). The authors reported that the massage-only group showed improvement on four RSCL subscales; however, these improvements did not reach statistical significance.
In a placebo-controlled, double-blind, randomized trial of bergamot inhalation aromatherapy compared with a pleasant smelling shampoo that did not contain essential oils, administered at the time of stem cell infusion in 37 children and adolescents undergoing stem cell transplant, aromatherapy was not found to be beneficial in reducing nausea, anxiety, or pain. As administered in this study, bergamot inhalation aromatherapy may have contributed to persistent anxiety after the infusion of stem cells. Although no more effective than placebo, parents receiving aromatherapy showed a significant decrease in their transitory anxiety during the period between the completion of their child's infusion and 1 hour after infusion. Nausea and pain subsided over the course of the intervention for all children, although nausea remained significantly greater in patients receiving aromatherapy. These findings suggest that the diffusion of bergamot essential oil may not provide suitable anxiolytic and antiemetic effects among children and adolescents undergoing stem cell transplantation. The double blinding of the trial may explain the results, as single-blinded or nonblinded trials in general supported the aromatherapy intervention.
A similar study evaluated the efficacy of an aromatherapy intervention for reduction of symptom intensity of nausea, retching, and/or coughing among adult patients receiving stem cells preserved in dimethyl sulfoxide. The study found that an intervention of tasting or sniffing sliced oranges was more effective at reducing symptom intensity than an orange essential oil inhalation aromatherapy.
A randomized controlled crossover clinical trial investigated the effect of inhaled ginger essential oil on alleviating chemotherapy-induced nausea and vomiting in Asian women with breast cancer. Aromatherapy administered as inhaled ginger essential oil for 5 days was associated with small, statistically significant, but not clinically significant, reductions in acute nausea but had limited effects on reducing vomiting or delaying nausea in 60 evaluable patients.
A study whose primary objective was evaluating an aromatherapy service following changes made after an initial pilot at a U.K. cancer center also reported on the experiences of patients referred to the service. Of 89 patients originally referred, 58 completed six aromatherapy sessions. The authors reported significant improvements in anxiety and depression (as measured by HADS) at the completion of the six sessions, as compared with before the six sessions. A small study examined the physical and psychological effects of aromatherapy massage in eight patients with primarymalignant brain tumors attending their first follow-up appointment after radiation therapy. The author reported no psychological benefit in these patients from aromatherapy massage (as measured by HADS) but reported a statistically significant reduction in blood pressure, pulse, and respiratory rate.
Antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus, are an increasing problem worldwide, causing intractable wound infections. Mixtures, such as those containing the volatile oils of lemongrass, eucalyptus, melaleuca, clove, and thyme with butylated hydroxytoluene, triclosan (0.3%), and 95% undenatured ethanol (69.7%), are being investigated against MRSA in vitro. No clinical trials have been performed.
Two topical MRSA eradication regimens were compared in hospital patients. A standard treatment, which included mupirocin 2% nasal ointment, chlorhexidine gluconate 4% soap, and silver sulfadiazine 1% cream was compared with a tea tree oil regimen (melaleuca), which included tea tree 10% cream and tea tree 5% body wash. Both treatments were administered for 5 days. Of 114 patients who received the standard treatment, 56 (49%) were cleared of MRSA carriage. Of 110 patients who received the tea tree oil regimen, 46 (41%) were cleared of MRSA carriage. In a small group of patients, the tea tree oil regimen was associated with a higher clearance rate of MRSA carriage in the axilla, groin, and wound sites, but the difference versus standard treatment was not significant.
Current Clinical Trials
Use our advanced clinical trial search to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. General information about clinical trials is also available.
- Cooke B, Ernst E: Aromatherapy: a systematic review. Br J Gen Pract 50 (455): 493-6, 2000.
- 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.
- 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.
- 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.
- Wilkinson S, Aldridge J, Salmon I, et al.: An evaluation of aromatherapy massage in palliative care. Palliat Med 13 (5): 409-17, 1999.
- 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.
- 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.
- Lua PL, Salihah N, Mazlan N: Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancer. Complement Ther Med 23 (3): 396-404, 2015.
- Kite SM, Maher EJ, Anderson K, et al.: Development of an aromatherapy service at a Cancer Centre. Palliat Med 12 (3): 171-80, 1998.
- 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.
- Sherry E, Boeck H, Warnke PH: Percutaneous treatment of chronic MRSA osteomyelitis with a novel plant-derived antiseptic. BMC Surg 1: 1, 2001.
- Dryden MS, Dailly S, Crouch M: A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization. J Hosp Infect 56 (4): 283-6, 2004.
Adverse Effects
Safety testing on essential oils has shown minimal adverse effects. Several essential oils have been approved for use as food additives and are classified as GRAS (generally recognized as safe) by the U.S. Food and Drug Administration; however, ingestion of large amounts of essential oils is not recommended. In addition, a few cases of contact dermatitis have been reported, mostly in aromatherapists who have had prolonged skin contact with essential oils in the context of aromatherapy massage. Some essential oils (e.g., camphor oil) can cause local irritation; therefore, care should be taken when applying them. Phototoxicity has occurred when essential oils (particularly citrus oils) are applied directly to the skin before sun exposure. One case report also showed airborne contact dermatitis in the context of inhaled aromatherapy without massage. Often, aromatherapy uses undefined mixtures of essential oils without specifying the plant sources. Allergic reactions are sometimes reported, especially after topical administration. As essential oils age, they are often oxidized so the chemical composition changes. Individual psychological associations with odors may result in adverse responses. Repeated exposure to lavender and tea tree oils by topical administration was shown in one study to be associated with reversible prepubertal gynecomastia. The effects appear to have been caused by the purported weak estrogenic and antiandrogenic activities of lavender and tea tree oils. Therefore, avoiding these two essential oils is recommended in patients with estrogen-dependant tumors. However, this is the first published report of this type of adverse effect when using products containing tea tree or lavender oils.
- Bilsland D, Strong A: Allergic contact dermatitis from the essential oil of French marigold (Tagetes patula) in an aromatherapist. Contact Dermatitis 23 (1): 55-6, 1990.
- Schaller M, Korting HC: Allergic airborne contact dermatitis from essential oils used in aromatherapy. Clin Exp Dermatol 20 (2): 143-5, 1995.
- Henley DV, Lipson N, Korach KS, et al.: Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med 356 (5): 479-85, 2007.
Summary of the Evidence for Aromatherapy and Essential Oils
To assist readers in evaluating the results of human studies of integrative, alternative, and complementary therapies 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, with a score of 1 being the strongest evidence and a score of 4 being the weakest design (or sometime similar). 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 integrative, alternative, and complementary therapies for people with cancer, refer to Levels of Evidence for Human Studies of Integrative, Alternative, and Complementary Therapies.
Table 1. Use of Aromatherapy as a Supportive Care Agent in Cancer and Palliative Care: Table of Clinical StudiesReference CitationsType of Study/Essential Oil/Mode of Administration No. of Patients Enrolled; Treated; ControlCondition InvestigatedPrimary OutcomeSecondary OutcomeLevel of Evidence ScoreEORTC QLQ-C30 = European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; HRQOL = health-related quality of life; No. = number; QOL = quality of life.aPatients with cancer.bPatients with breast cancer undergoing chemotherapy.cPatients with breast cancer undergoing bone marrow transplantation.dPatients with malignant brain tumors.eLavender (43%), rosewood (29%), rose (7%), and valerian (4%).Randomized nonblinded triala/lavender (Lavandula angustifolia Miller [synonyms: Lavandula spicata L.; Lavandula vera DC.]) and chamomileblend/massage46; 11; 18Mood, QOL, physical symptomsNo effect on mood, QOL, or physical symptomsNone1iiRandomized nonblinded triala/lavender/ massage42; 29; 13PainNo effect on painImproved sleep in both groups; reduced depression (in massage group); no effect on QOL1iiRandomized nonblinded triala/chamomile/massage103; 43; 44Physical and psychological symptoms, QOLReduction in anxiety and in physical and psychological symptoms; improved QOLNone1iiRandomized nonblinded triala/chamomile/massage52; 26; 25QOL, physical symptoms, anxietyImproved QOL, fewer physical symptoms, reduced anxietyNone1iiRandomized nonblinded triala/aromatherapy blende/massage52; 34; 18Anxiety, mobilityDecreased anxiety, pain; improved mobilityNone1iiDouble-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 application313AnxietyNo effect on anxietyNo effect on depression or fatigue1iRandomized placebo-controlled double-blind trial/bergamot/ inhalation37; 17; 20Anxiety, nausea, pain in children undergoing stem cell transplantIncreased anxiety and nausea in children 1 hour after stem cell infusion in aromatherapy group; no effect on painParental anxiety declined in both groups1iCRandomized controlled single-blind trial/sweet orange/inhalation60; 23; 19; 18 (aromatherapy; orange tasting/sniffing; control)Symptom intensity (nausea, retching, cough)Greatest reduction in symptom intensity with orange tasting/sniffingNone1CRandomized controlled, single-blind, crossover trialb/ginger essential oil/inhalation75; 30; 30Nausea, vomiting, HRQOL (EORTC QLQ-C30)Small reduction in acute nausea; no reduction in delayed nausea or vomiting episodesImproved HRQOL1CRandomized single-blind trial/choice of 20 essential oils/massage39; 20; 19Feasibility; moodImprovements in mood in both groups (aromatherapy massage and cognitive behavioral therapy)Preference for aromatherapy over cognitive behavior therapy1CRandomized single-blind trial/choice of bitter orange, black pepper, rosemary, marjoram, and patchouli/massage45; 15; 15; 15 (aromatherapy massage; plain massage; control)Constipation; QOLImprovement with aromatherapy massageImproved QOL1CNonrandomized controlled clinical trialc/lavender, eucalyptus (Eucalyptus globulus Labill. and Eucalyptus radiata Sieber ex DC. [Myrtaceae]), and tea tree/topical application16; 6; 10InfectionNo effect on incidence of infectionNone2Nonrandomized controlled clinical trialc/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 turmeric phytol/oral application48; 24; 24Gastrointestinal symptomsNo effect on gastrointestinal symptomsNone2Consecutive case seriesd/lavender or chamomile/massage18; 8Anxiety, depressionNo reduction in anxiety or depressionReduction in blood pressure, pulse, and respiration 3iiConsecutive casea/various oils/massage69General symptomsGeneral improvement in symptoms reported by patients; no statistical analysis completed None3ii
- 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.
- 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.
- Wilkinson S, Aldridge J, Salmon I, et al.: An evaluation of aromatherapy massage in palliative care. Palliat Med 13 (5): 409-17, 1999.
- 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.
- 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.
- 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.
- Lua PL, Salihah N, Mazlan N: Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancer. Complement Ther Med 23 (3): 396-404, 2015.
- 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.
- 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.
- 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.
- 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.
Changes to This Summary (02/07/2018)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
This summary is written and maintained by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.
About This PDQ Summary
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of aromatherapy and essential oils in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
- be discussed at a meeting,
- be cited with text, or
- replace or update an existing article that is already cited.
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Aromatherapy and Essential Oils are:
- John A. Beutler, PhD (National Cancer Institute)
- Kara Kelly, MD (Women & Children's Hospital of Buffalo & Roswell Park Cancer Institute)
- Elena J. Ladas, PhD, RD (Columbia University)
Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's Email Us. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Integrative, Alternative, and Complementary Therapies Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
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PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary]."
The preferred citation for this PDQ summary is:
PDQ® Integrative, Alternative, and Complementary Therapies Editorial Board. PDQ Aromatherapy and Essential Oils. Bethesda, MD: National Cancer Institute. Updated
Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online, a collection of over 2,000 scientific images.
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Jelastic has bolstered the breadth of its cloud hosting PaaS offering for Java and PHP applications by releasing a plugin for IntelliJ IDEA, one of the most popular Java IDEs.
JetBrains IntelliJ IDEA features smart code completion, multi-language editing, and a flexible cross-platform UI. The developer proposition here is the option to manage environments and deploy apps from the IDE without having to switch to a browser.
"Jelastic is all about empowering developers and making hosting easy. With the Jelastic plugin, IDEA users can work with their development, test, and production deployments without leaving their favorite Java IDE," said Jelastic COO Dmitry Sotnikov.
Key features of the Jelastic plugin for IntelliJ IDEA include options to work with different hosting providers; the ability to deploy and redeploy applications; the ability to view and manage user environments; and the ability to view logs (full logs and tail logs).
"In IntelliJ IDEA 12 we have taken our first steps toward supporting deployment tools for clouds," said Andrey Chepstov, IntelliJ IDEA product marketing manager. "Of course, we welcome the authors of Jelastic, a Duke's Choice Award winning platform, to contribute to the IntelliJ IDEA plug-in ecosystem."
Jelastic's plugin can be installed automatically from IntelliJ IDEA plugin repositories.


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Nan is 98 years old now and lives in the Alzheimer's unit at Scalabrini nursing home in Rhode Island. She doesn't remember much any more. She doesn't remember me. She usually forgets my mother, who visits her every day. When I saw Nan last month for Christmas, I tried to prompt her. "Nan, remember me? Your granddaughter? Susan?" Nothing.
On the last day that Jeff and I lived in Rhode Island before moving to North Carolina, we slept over Nan's house, with a full U-haul truck parked in the driveway. When we awoke, it was raining as hard as I can ever remember. It was January 1997. My grandmother, a notorious late sleeper, got up at 4:00 am that bitter cold morning and made us breakfast. We woke to the warm, sweet smell of waffles from her vintage waffle iron and to the gurgling sound of her electric coffee percolator. They were the best tasting waffles I had ever had and have had since that day.
I provoked her again: "Remember me Nan? I'm your granddaughter, Susan. I'm married to Jeff" (she loves Jeff). Still nothing. "Remember when you made us waffles?" "Waffles?" she answered. "Yeah, that rainy morning." Her eyes lit up. "Oooh, yeah," she said. "I made you waffles." Tears were welling up in my eyes. "Waffles and coffee, huh?" she added. "Yeah, Nan, waffles and coffee," I repeated. "I was a good cook, huh?" she asked me. Tears were just flowing now. "Yeah Nan, you were a good cook."
I made Nan's lentil soup last night because we were missing her, our families, and Rhode Island. Whenever we feel this way, we try to make some type of Italian comfort food that our mothers and grandmothers used to make for us. Somehow, it always transports us, albeit briefly, back home.
I don't know if this recipe is exactly like Nan's, but she probably wouldn't either. That's because she never used a recipe. Ever. I have inherited that from her; I often don't measure, and I rarely follow a recipe exactly (which is why you never want to come over my house for souffle).
Nan's Italian Lentil Soup
Makes 4 servings.
Print recipe only here.
1 tablespoon olive oil
1 onion, diced
2 celery stalks, diced
2 carrots, diced
1/2 cup lentils, brown or black*
2 bay leaves
4-5 cups water (depending on your desired soupiness)
1 8-oz can tomato sauce or diced tomatoes with juice
A good shake of red pepper flakes
Salt, to taste
About 2 Tbsp of chopped fresh basil
About 2 Tbsp of chopped fresh parsley
Some good Reggiano-Parmigiano and quality extra virgin olive oil
Remove the pan from the heat. And remove the bay leaves before serving! Add the fresh herbs now so they will retain their bright green color and fresh flavor. Top with lots of good grated cheese, and drizzle some quality extra virgin olive oil on top.
*TIP: I love Trader Joe's black lentils. They have an earthier flavor and don't break down as easily as brown lentils. They also create a thicker soup perfect for clinging to a nice piece of crusty Italian bread. Mmm.
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Contemporary Ömie Bark Cloth
Boldly patterned with graphic designs, the bark cloth that is made by Ömie women in the Oro province of Papua New Guinea expresses a great diversity of abstracted elements from the natural world. The painted cloths can relay creation stories or represent tattoo patterns that were once important to initiation ceremonies. The making of contemporary bark cloth in the Ömie territory is the exclusive creative and spiritual domain of 71 women artists. The cloth is crafted only by female chiefs and only within the community's territory.
Support for this exhibition comes from The Christensen Fund
Aspesa Gadai, Odunaige (Climbing vine with thorns and tendrils) 2006. Jiapa village, Oro Province, Papua New Guinea. Natural pigments nioge(barkcloth). 176.0 x 76.0 cm. National Gallery of Victoria, Melbourne. Purchased NGV Foundation, 2008 (2008.73). © The artist, courtesy Ömie Nemiss Incorporated


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Just when Jon Lovett thought he was out of politics, they pulled him back in. The 30-year-old former stand-up comic toiled over speeches for President Obama for three years before he quit in September 2011 to pursue comedy writing in Hollywood. "The one thing I didn't want to do was a show about the White House," he says. "I was too close to it." But on January 9, Lovett returned to the Beltway, where his old boss hosted a screening of 1600 Penn, the new NBC sitcom about a dysfunctional first family that Lovett cocreated with its star Josh Gad (The Book of Mormon) and former Modern Family producer Jason Winer.
"It was sort of fortuitous," Winer says. "Josh and I came up with the idea, but we were a little daunted by it because we could write the family stuff but we weren't confident enough to handle the White House details. Jon had just come to Los Angeles and we were introduced. I said, 'This is crazy. This guy has never written anything narrative before.' But there's nobody who knows this world better."
The idea of using the White House to depict an ordinary family in an extraordinary situation attracted Lovett, who was doing stand-up before he interned for John Kerry's 2004 presidential campaign. That led to stints as a Capitol Hill press aide and as a speechwriter for Hillary Clinton. While on President Obama's staff, Lovett helped craft messages on the financial crisis and health-care reform, but he also provided the commander in chief's zingers for such occasions as the White House Correspondents' Dinner.
Lovett's imprint on the early episodes of 1600 Penn is most prominent in the depiction of an unruly Washington press corps. "The press on the show does the same job that they do in real life," he says. "They're ridiculous. They have a hive mentality. But they hold everybody's feet to the fire. That balance of being completely annoying and totally necessary is part of the fun of the show."
In an upcoming episode, Lovett offers a peek into the speechwriters' room when President Gilchrist, played by Bill Pullman, needs to praise someone publicly whom he doesn't like. "I've lived that," Lovett says. "Finding the words isn't always easy."
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Definition of ventral diaphragm
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Modern functional programming languages such as F# reduce development time and make it easy to perform rapid prototyping for complex algorithms. One of the most interesting features of F# 3.0, which is now a first-class citizen in Visual Studio 2012, is its ability to do algorithmic analysis on large data sets. In particular, it offers a uniform approach for continuously changing data sources, which is termed Information Rich Programming. In this first article in a series dedicated to Information Rich Programming with F# 3.0, I'll provide an overview of the new F# Type Providers and how they can boost your productivity and solve common problems when accessing continuously changing data sources and Internet-scale information sources.
IntelliSense and a SQL Server Database
I'll start with a very simple example that enables you to understand the productivity boost that you can expect with the new type providers and learn their basic features. Even if you don't have previous experience with either F# or functional programming languages, you will be able to see why type providers are one of the most important features in F# 3.0.
Figure 1 shows a schema with the entities and the relationships of a Retrogames database that I've used in many data-oriented examples in the past. The database has the following entities:
- Game
- GameCategory
- Gender
- Player
- PlayerScore
Figure 1: Entities and their relationships for the Retrogames SQL Server database.
Each game must have a category. Each time a game ends for a player, a service inserts the score in the
PlayerScore table. Each player must have a gender (male or female) defined in the
Gender table). I'll use Retrogames as the database name. You can run the following script in SQL Server 2008 or 2012 in order to create the database structure for this example:
CREATE TABLE dbo.GameCategory ( GameCategoryId int NOT NULL, Name varchar(50) NOT NULL, CONSTRAINT PK_GameCategory PRIMARY KEY CLUSTERED (GameCategoryId ASC) ) GO CREATE UNIQUE INDEX IX_GameCategory ON dbo.GameCategory ( Name ASC ) GO CREATE TABLE dbo.Gender ( GenderId int NOT NULL, Description varchar(20) NOT NULL, CONSTRAINT PK_Genre PRIMARY KEY CLUSTERED (GenderId ASC) ) GO CREATE UNIQUE INDEX IX_Genre ON dbo.Gender ( Description ASC ) GO CREATE TABLE dbo.Game ( GameId int NOT NULL, Name varchar(50) NOT NULL, ReleaseDate date NOT NULL, GameCategoryId int NOT NULL, Played bit NOT NULL, CONSTRAINT PK_games PRIMARY KEY CLUSTERED (GameId ASC) ) GO CREATE UNIQUE INDEX IX_games ON dbo.Game ( Name ASC ) GO CREATE INDEX IX_games_1 ON dbo.Game ( ReleaseDate ASC ) GO CREATE INDEX IX_Game ON dbo.Game ( Played ASC ) GO ALTER TABLE dbo.Game ADD CONSTRAINT FK_Game_GameCategory FOREIGN KEY (GameCategoryId) REFERENCES dbo.GameCategory(GameCategoryId) ON DELETE CASCADE GO CREATE TABLE dbo.Player ( PlayerId int NOT NULL, Name varchar(50) NOT NULL, GenderId int NOT NULL, CONSTRAINT PK_Player PRIMARY KEY CLUSTERED (PlayerId ASC) ) GO CREATE UNIQUE INDEX IX_Player ON dbo.Player ( Name ASC ) GO ALTER TABLE dbo.Player ADD CONSTRAINT FK_Player_Genre FOREIGN KEY (GenderId) REFERENCES dbo.Gender(GenderId) GO CREATE TABLE dbo.PlayerScore ( PlayerScoreId int NOT NULL, PlayerId int NOT NULL, GameId int NOT NULL, Score bigint NOT NULL, ScoreDate date NOT NULL, CONSTRAINT PK_PlayerScore PRIMARY KEY CLUSTERED (PlayerScoreId ASC) ) GO ALTER TABLE dbo.PlayerScore ADD CONSTRAINT FK_PlayerScore_Player FOREIGN KEY (PlayerId) REFERENCES dbo.Player(PlayerId) GO ALTER TABLE dbo.PlayerScore ADD CONSTRAINT FK_PlayerScore_Game FOREIGN KEY (GameId) REFERENCES dbo.Game(GameId) GO
If you use Server Explorer in Visual Studio 2012 (known as Database Explorer in the Express edition), you can easily establish a connection to the database and navigate through the database structure. It is easy to discover the tables and their columns (see Figure 2), even with the horrible monochrome icons that Visual Studio 2012 brought with its UI (colors are so useful for developers and architects). Of course, you always have the diagrams, but my focus is on how simple it is to review the schema in real-time in the IDE.
Figure 2: Server Explorer allowing you to navigate through the database structure.
If you use Microsoft SQL Server Management Studio to build queries and you have IntelliSense enabled, you can benefit for auto-completion. I must say that even the simplest IntelliSense included by default in Microsoft SQL Server Management Studio makes me more productive and reduces my error rate whenever I write a SQL query, because I don't make mistakes with either table or column names, and I reduce my memory consumption. There are more powerful tools that boost productivity when you write too many queries per hour, but that isn't the main topic for this article.
Thus, developers and architects are already used to taking advantage of IntelliSense when they write queries against a SQL Server database. Of course, the database schema must be kept up-to-date. However, you don't have to remember the exact field names because IntelliSense provides them to you. For example, if you need to calculate the maximum score for year 2012, with the help of IntelliSense, you don't need to remember either table or column names to generate the following query (see Figure 3).
SELECT MAX(P.Score) FROM PlayerScore P WHERE P.ScoreDate BETWEEN '2012-01-01' AND '2011-12-31' GO
Figure 3: SQL Server Management Studio auto-completion features in action.


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This headstone is at the grave of James Harker and his wife Dinah (Dawson) at Holy Trinity church, Cowling, West Yorkshire.
Dinah is my 2nd cousin 3x removed – our common ancestors are my 4x great grandparents John Dawson and Ann Watson. Dinah was born in Cowling on 5 May 1853 to parents James Wright Dawson and Mary Thompson.
Sometime in Q3 of 1874 Dinah married James Harker, also from Cowling. I haven't done any research on James so at the moment I can't tell you who is parents are.
James and Dinah had at least two children – Martha (c 1878) and Edith (c1880).
Between 1881 and 1911 James worked as warp loomer, presumably in one of local mills. Dinah worked as a weaver until in the 1901 census she is described as 'confectioner, own account'. In 1911 her occupation is 'confectioner sweets'. I have this image of Dinah running her own sweet shop – you know the sort I mean, with large jars of sweets of all different kinds.
In 1911 the family was living at 121 Keighley Road, Cowling (see photograph below). I wonder if Dinah was running her confectionery business from this address.
James died on 28 July 1924 at the age of 73 and Dinah passed away on 9 September 1932 aged 79.