Essential Oils May Provide Relief from Chemotherapy-Induced Nausea and Vomiting

Lisa Demont, BSN, RN, OCN

Ginger and peppermint pure essential oils reduced the severity of chemotherapy-induced nausea and vomiting in newly admitted patients receiving autologous blood and marrow transplants (BMTs) and may serve as a beneficial complimentary treatment, according to Lisa Demont, BSN, RN, OCN.¹

Essential oils are volatile liquid substances extracted from aromatic plant material available for inhalation or topical treatment in the United States.² In a controlled randomized study presented by Demont during the 2023 Transplantation & Cellular Therapy Meetings, patients (n = 60) either received 100% pure essential peppermint oil (n = 19), 100% pure essential ginger oil (n = 21), and the control group received canola oil (n = 20). The meeting took place from February 15 to 19, 2023, in Orlando Florida.¹

“[The peppermint essential oils group experienced the lowest rate of nausea [15%], followed by ginger [33%], and control [52%; P = .045],” Demont, the clinical nurse leader on the Blood and Marrow Transplant and cellular immunity unit at Moffitt Cancer Center in Tampa, Florida, wrote in her presentation.

Overall, 33% of patients in the study experienced a grade 2 or higher CTCAE nausea event. Grade 2 vomiting occurred in 8% of patients overall, including 2, 1, and 2 patients in the peppermint, ginger, and control arms experiencing the event, respectively.¹

Nurses administered the treatment by applying the oils to a gauze and pinning it to the patients clothing 20 cm from the nostrils every 4 hours. In addition to measuring nausea and vomiting subjectively as well as objectively, at the end of the study patients completed a patient feedback tool.¹

Patient feedback demonstrated that “6 patients in the essential oils groups [4 peppermint and 2 ginger] made subjective comments indicating that the scent was too strong and may have increased nausea.” Five of the 6 patients withdrew early from the study. The study competition rate was 63% in the peppermint group, 72% in the ginger, and 84% in the control (P = .12).¹

Prior to the study, 55% of patients had experienced nausea as a result of chemotherapy and 42% of patients had used an essential oil with 45% of the peppermint arm, 62% of the ginger, and 16% of the control having prior aromatherapy experience (P=.012).¹

When examining the variables patients self-reported on a scale of 1 to 5 in the feedback tool, there was not a statistically significant difference in how pleasing and tolerable patients found the study. The mean was 2.74 in the peppermint group, 3.27 in the ginger, and 3.33 in the control (P=.33) and satisfaction rates for route of delivery were 3.05, 3.33, and 4.0, respectively (P = .05).¹

The study took place at the Moffitt Cancer Center’s BMT-Cellular Immunotherapy units and patients were treated with melphalan or the BEAM regimen of carmustine, etoposide, cytarabine, and melphalan with/without rituximab (Rituxan). Most patients were being treated for multiple myeloma (62%),60% were female, and 78% were White.¹

Demont noted that, along with prior use of essential oils, a potential confounder of the study includes the chemotherapy regimen given which may impact the severity of chemotherapy-induced nausea and vomiting.¹

Limitations of the study include the small sample size and, due to patients being randomly assigned to previous essential oil use and prior chemotherapy-induced nausea and vomiting, there was an imbalance in crucial variables. This data was only explored in a BMT setting as well and the reasons patients previously used essential oils was not investigated. The study also only included patients admitted to Moffitt Cancer Center for an autologous transplant.¹

The use of ginger essential oil as an aromatherapy was also supported by data from a study published in Oncology Nursing Forum. Findings from the study showed that ginger essential oil produced statistically significant results, decreasing levels of fatigue (P = .048) in patients with gastrointestinal, neuroendocrine, or skin cancer who were receiving intravenous therapy.³

As patients experience acute and delayed chemotherapy-induced nausea and vomiting even when receiving antiemetics with chemotherapy when preparing for surgery, essential oils may serve as an additional beneficial complimentary therapy option and patients can control the administration of the oil themselves. With a larger more diverse sample, future studies may evaluate the route of delivery, the use of blended essential oils, intermittent use, how the treatment affects safety, as well as use with antiemetic medications.¹

References

1. Dermont L, Parnell C, Perez V, et al. Complimentary use of essential oils in the autologous blood and marrow transplant population: chemotherapy-induced nausea and vomiting. Transplantation and Cellular Therapy Meetings; February 15-19, 2023; Orlando FL. Accessed February 22, 2023. Abstract 99.
2. Aromatherapy with essential oils (PDQ®): health professional version. National Cancer Institute; January 13, 2023. Accessed February 22, 2023. bit.ly/3m7oniT
3. Williams AS, Dove J, Krock JE, et al. Efficacy of inhaled essential oil use on selected symptoms affecting quality of life in patients with cancer receiving infusion therapies. Oncol Nurs Forum. 2022;49(4):349-358. doi:10.1188/22.ONF.349-358