2025-12-31
Aromatherapy in patients with cancer: hope for anxiety, but not for depression?
Oncology
By Lila Rouland | Published on December 31, 2025 | 3 min read
Anxiety and depression affect a substantial proportion of people with cancer, severely impacting quality of life and adherence to treatment. Although psychotropic medications are commonly prescribed, their side effects (drowsiness, dependence, headaches) justify the growing interest in complementary therapies, including aromatherapy. This approach uses essential oils to relieve psychological symptoms via inhalation or massage. However, its clinical effectiveness remains debated.
This systematic review and meta-analysis, conducted according to PRISMA guidelines, aimed to assess the impact of aromatherapy on anxiety, depression, and psychological well-being in people with cancer. The analysis included 17 randomized controlled trials (n = 1,611) published up to May 2021.
Most included studies assessed anxiety (n = 15), fewer assessed depression (n = 6), and even fewer assessed psychological well-being (n = 5). Aromatherapy modalities varied: massage alone, inhalation, or a combination of both. Lavender was the most frequently used essential oil.
Meta-analyses of 10 studies (n = 823) showed a moderate but significant effect of aromatherapy in reducing anxiety (SMD = −0.49; p < 0.05). Aromatherapy massage was more effective (SMD = −0.70; p < 0.005) than inhalation alone. Short interventions (< 4 weeks) also showed greater effectiveness (SMD = −0.87; p < 0.05). Notably, studies conducted in Asia reported more positive results (SMD = −0.83; p < 0.05) than European studies, likely reflecting greater cultural acceptance of natural therapies.
Among the oils, lavender stood out for its anxiolytic effects (SMD = −1.12; p < 0.01), attributed to its components (linalool, linalyl acetate), which act on GABA receptors. The proposed mechanism includes activation of the limbic system via olfaction, as well as a direct pharmacological effect.
In contrast, no significant benefit of aromatherapy on depression was demonstrated across the six analyzed studies. Only one study showed a reduction in depressive scores, whereas the others—using validated scales (HADS, CES-D, POMS)—found no clinically meaningful improvement. This lack of effectiveness may be explained by the severity of depressive symptoms in this population and by intervention durations that were too short (maximum 10 weeks) to achieve effects comparable to standard antidepressants.
Only five studies measured this outcome, with overall non-significant results. One Turkish study using a mixed protocol (massage + inhalation) reported improvement, but the others did not confirm this benefit.
Aromatherapy—particularly lavender-based massage—appears to offer an effective complementary option for relieving anxiety in people with cancer, especially in short-term interventions and in Asian contexts. By contrast, its effects on depression and overall psychological well-being remain uncertain.
Study limitations include high heterogeneity (I² = 90%), the absence of double-blinding in many trials (difficult to implement in aromatherapy), and poorly standardized intervention protocols. In addition, the essential oils used, their dosages, and application methods varied widely, limiting comparability.
Future research should rely on rigorous controlled trials with standardized essential oils, longer intervention durations, and detailed assessment of physiological and psychological effects. It would also be relevant to examine synergistic effects of aromatherapy combined with other mind–body approaches within an integrated oncology care strategy.
About the author – Lila Rouland
With dual expertise in science and marketing, Lila brings her knowledge to the service of healthcare innovation. After five years in international academic research, she transitioned into medical and scientific communication within the pharmaceutical industry. Now working as a medical writer and content developer, she is committed to highlighting scientific knowledge and conveying it to healthcare professionals with clarity and relevance.
Anxiety and depression affect a substantial proportion of people with cancer, severely impacting quality of life and adherence to treatment. Although psychotropic medications are commonly prescribed, their side effects (drowsiness, dependence, headaches) justify the growing interest in complementary therapies, including aromatherapy. This approach uses essential oils to relieve psychological symptoms via inhalation or massage. However, its clinical effectiveness remains debated.
This systematic review and meta-analysis, conducted according to PRISMA guidelines, aimed to assess the impact of aromatherapy on anxiety, depression, and psychological well-being in people with cancer. The analysis included 17 randomized controlled trials (n = 1,611) published up to May 2021.
Same effectiveness for everyone? When aromatherapy depends on protocol and symptom
Most included studies assessed anxiety (n = 15), fewer assessed depression (n = 6), and even fewer assessed psychological well-being (n = 5). Aromatherapy modalities varied: massage alone, inhalation, or a combination of both. Lavender was the most frequently used essential oil.
Effect on anxiety
Meta-analyses of 10 studies (n = 823) showed a moderate but significant effect of aromatherapy in reducing anxiety (SMD = −0.49; p < 0.05). Aromatherapy massage was more effective (SMD = −0.70; p < 0.005) than inhalation alone. Short interventions (< 4 weeks) also showed greater effectiveness (SMD = −0.87; p < 0.05). Notably, studies conducted in Asia reported more positive results (SMD = −0.83; p < 0.05) than European studies, likely reflecting greater cultural acceptance of natural therapies.
Among the oils, lavender stood out for its anxiolytic effects (SMD = −1.12; p < 0.01), attributed to its components (linalool, linalyl acetate), which act on GABA receptors. The proposed mechanism includes activation of the limbic system via olfaction, as well as a direct pharmacological effect.
Read next: Metastatic breast cancer: can plants change the game?
What is the effect of aromatherapy on depression?
In contrast, no significant benefit of aromatherapy on depression was demonstrated across the six analyzed studies. Only one study showed a reduction in depressive scores, whereas the others—using validated scales (HADS, CES-D, POMS)—found no clinically meaningful improvement. This lack of effectiveness may be explained by the severity of depressive symptoms in this population and by intervention durations that were too short (maximum 10 weeks) to achieve effects comparable to standard antidepressants.
Does aromatherapy improve psychological well-being?
Only five studies measured this outcome, with overall non-significant results. One Turkish study using a mixed protocol (massage + inhalation) reported improvement, but the others did not confirm this benefit.
Conclusion & perspectives: a complementary tool, not a disease-modifying treatment
Aromatherapy—particularly lavender-based massage—appears to offer an effective complementary option for relieving anxiety in people with cancer, especially in short-term interventions and in Asian contexts. By contrast, its effects on depression and overall psychological well-being remain uncertain.
Study limitations include high heterogeneity (I² = 90%), the absence of double-blinding in many trials (difficult to implement in aromatherapy), and poorly standardized intervention protocols. In addition, the essential oils used, their dosages, and application methods varied widely, limiting comparability.
Future research should rely on rigorous controlled trials with standardized essential oils, longer intervention durations, and detailed assessment of physiological and psychological effects. It would also be relevant to examine synergistic effects of aromatherapy combined with other mind–body approaches within an integrated oncology care strategy.
Read next: Rehabilitation, an often underestimated lever
About the author – Lila Rouland
Doctor of Oncology, specialized in Biotechnology and Management
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