Efficacy of Essential Oils in Relieving Cancer Pain: A Systematic Review and Meta-Analysis

Efficacy of couple-based dyadic interventions on the relationship outcomes of couples with cancer: A systematic review and network meta-analysis

PURPOSE

To compare the effects of different couple-based dyadic interventions on patient-partner couple's relationship outcomes.

METHODS

A systematic search of the nine databases, Cochrane Library, MEDLINE, PubMed, Embase, Web of Science, CINHAL, PsyclINFO, China National Knowledge Infrastructure and WanFang was conducted from database inception to October 22, 2024 for randomized controlled trials (RCTs) of patients with cancer and their partners receiving couple-based dyadic interventions. The outcome indicators included couple relationship quality. The results were plotted and presented by Stata 14.0. The surface under the cumulative ranking area (SUCRA) was employed for intervention level estimation.

RESULTS

This study included 2519 patients with cancer and their partners from 25 RCTs. For patients with cancer, supportive care demonstrated the largest effect size in improving couples' relationships (standardized mean difference [SMD]: -0.69; 95% confidence intervals [CI]: -1.15,-0.23) and had the highest cumulative probability (SUCRA: 69.4%) compared to skills training. Mindfulness demonstrated the largest effect size for partners in improving relationships of couples (SMD: -0.51, 95% CI: -0.98,-0.05) and had the highest cumulative probability (SUCRA: 87.2%) compared to skills training.

CONCLUSIONS

Mindfulness represents the most promising couple-based dyadic intervention for improving relationship quality between partners of patients with cancer. However, no significantly effective interventions have been identified to enhance couple relationships for patients. Future research should consider the requirements of patients and partners who are the units, and develop more targeted programs to facilitate relationship adjustment. The results provide a low level of certainty, suggesting the need for further rigorous studies to validate these findings.

Summary of evidence on Traditional Chinese Medicine nursing interventions in hospice care for patients with advanced cancer

BACKGROUND

Patients with advanced cancer experience physical and psychological pain that affects their quality of life. This review aimed to systematically search, evaluate, and summarize the best evidence on Traditional Chinese Medicine (TCM) nursing interventions in hospice care for patients with advanced cancer and to provide an evidence-based foundation for clinical care. The time limit for the search was from 2010 to September 2024.

METHODS

A top-down search of relevant literature was conducted according to the "6S" evidence model, including clinical decisions, guidelines, best practices, evidence summaries, systematic reviews, expert consensus, and randomized controlled trials (RCTs). The literature was evaluated, and evidence was extracted independently by two researchers. The evidence was appraised using the Appraisal of Guidelines Research and Evaluation (AGREE) tool and integrated with an evidence-based team consisting of six members.

RESULTS

Thirty-three publications were included, including four guidelines, two expert consensus, two clinical decisions, two evidence summaries, twenty-one systematic reviews, and two RCTs. Thirty-six indicators of best evidence were summarized from eight areas: TCM therapy, acupuncture therapy, moxibustion therapy, acupressure therapy, music therapy, traditional Chinese exercise therapy, auricular therapy, and aromatherapy.

CONCLUSION

This review summarizes the best evidence for TCM nursing interventions in hospice care for patients with advanced cancer, which can be used by clinical healthcare professionals to develop appropriate TCM nursing interventions in combination with the actual situation and with full consideration of the needs and wishes of the patients and their families to improve the patients' quality of life in advanced stages.

In Vitro and In Silico Evaluation of Syzygium aromaticum Essential Oil: Effects on Mitochondrial Function and Cytotoxic Potential Against Cancer Cells

The current study proposes the in vitro and in silico anticancer evaluation of clove (Syzygium aromaticum L.) essential oil (CEO). The steam hydrodistillation method used yielded 10.7% (wt) CEO. GC-MS analysis revealed that the obtained oil is rich in eugenol (75%), β-caryophyllene (20%), and α- caryophyllene (2.8%) and also contains several other minor components accounting for approximately 1.5%. The DPPH-based scavenging antioxidant activity was assessed for the obtained CEO, exhibiting an IC50 value of 158 μg/mL. The cytotoxic effects of CEO, its major component eugenol, and CEO solubilized with Tween-20 and PEG-400 were tested against both noncancerous HaCaT cells and HT-29 human colorectal adenocarcinoma, RPMI-7951 melanoma, A431 skin carcinoma, and NCI-H460 non-small lung cancer cells, using the Alamar Blue and LDH assay after 48 h treatment. The Tween-20 and PEG-400 CEO formulations, at 200 μg/mL, recorded the highest cytotoxic and selective effects against RPMI-7951 (72.75% and 71.56%), HT-29 (71.51% and 45.43%), and A431 cells (61.62% and 59.65%). Furthermore, CEO disrupted mitochondrial function and uncoupled oxidative phosphorylation. This effect was more potent for the CEO against the RPMI-7951 and HT-29 cells, whereas for the other two tested cell lines, a more potent inhibition of mitochondrial function was attributed to eugenol. The present study is the first to specifically investigate the effects of CEO and Tween-20 and PEG-400 CEO formulations on the mitochondrial function of RPMI-7951, HT-29, A431, and NCI-H460 cancer cell lines using high-resolution respirometry, providing novel insights into their impact on mitochondrial respiration and bioenergetics in cancer cells. The results obtained may explain the increased ROS production observed in cancer cell lines treated with eugenol and CEO. Molecular docking identified potential protein targets, related to the CEO anticancer activity, in the form of PI3Kα, where the highest active theoretical inhibitor was calamenene (-7.5 kcal/mol). Docking results also showed that calamenene was the overall most active theoretical inhibitor for all docked proteins and indicated a potential presence of synergistic effects among all CEO constituents.

Effects of Aromatherapy on Quality Of Life and Pain In Patients With Cancer: A Meta-Analysis

CONTEXT

Cancer has become a chronic disease to which new therapeutic approaches are being applied and many patients are interested in the long-term consequences of these approaches. Aromatherapy is one approach that has been used as a safe and comfortable method to alleviate symptoms in patients with cancer, and its effects on various aspects of life have been reported.

OBJECTIVES

A systematic review and meta-analysis were conducted to examine the effects of aromatherapy on quality of life (QoL) and pain in patients with cancer.

METHODS

Using a comprehensive search strategy, 11 databases were searched from their inception to July 2023 for randomized controlled trials. In the meta-analysis, the standardized mean difference and 95% confidence interval were calculated as effect measures by applying a random effects model.

RESULTS

Fifteen studies met the inclusion criteria. Aromatherapy was found to have favorable effects in improving QoL (Hedges' ĝ = 0.62, 95% CI: 0.24-1.00), but no statistically significant effect of aromatherapy on pain was found (Hedges' ĝ = -0.46, 95% CI: -0.99 to 0.07).

CONCLUSION

The findings indicate statistically significant improvements in QoL when combining aromatherapy and massage, but it was not possible to disentangle the individual effects of each. Considering the characteristics of cancer patients, aromatherapy has beneficial effects as a non-pharmacological method. Further research is needed to investigate the effect of aromatherapy on symptom management, considering factors such as the duration of cancer development and type of cancer.

Enhancing placebo analgesia: Unravelling the powerful interplay of ownership and verbal suggestion

BACKGROUND

Placebo analgesic research demonstrates pain reduction after using a placebo analgesic. Recent studies have documented that sometimes possessing a placebo analgesic induces placebo analgesia. These prior studies used a 'cream' as the stimulus and proposed that the effect is driven by an expectancy of obtaining benefits from the owned analgesic. This paper examines three pivotal components of placebo analgesia: placebo form, ownership and expectancy induced by verbal suggestion. We investigate analgesic expectancy between cream versus oil form of placebo stimulus and systematically isolate the effects of ownership, verbal suggestion and their interaction, comparing with the effect of use, to decipher the dynamics of placebo analgesia.

METHODS

Study 1 (N = 46) evaluated analgesic expectancy between cream and oil. Study 2 (N = 119) exposed participants to a placebo analgesic oil and randomized them into PU (possess and use), PA (possess and anticipate), P (possess-only) or A (anticipate-only) conditions. Pain outcomes were assessed using a cold pressor test. Comparing PA and P conditions assessed the verbal suggestion effect, comparing PA and A conditions evaluated the possession effect, while comparing PU and PA conditions shed light on the use effect.

RESULTS

In Study 1, participants showed comparable analgesic expectancy for cream and oil. In Study 2, both PA and PU groups performed equally well, reporting higher pain threshold, F(3, 115) = 5.14, p = 0.002,η p 2  = 0.12; and a greater probability of persistent hand submersion than P and A groups, X2(3) = 8.06, p = 0.045.

CONCLUSION

The findings highlight the significance of integrating possession with expectancy to induce placebo analgesia, which has clinical implications.

SIGNIFICANCE

This study delves into the intricate dynamics of placebo analgesia, shedding light on the significant influence of ownership and verbal suggestion. Through a meticulous exploration of the relationship between ownership and expectancy induced by verbal suggestion, we propose novel avenues for enhancing placebo responses. This research has implications for clinical practice and pain management strategies, potentially revolutionizing approaches to pain relief and therapeutic outcomes. Our findings contribute to a paradigm shift in understanding placebo analgesia, emphasizing the pivotal interaction between ownership and verbal suggestion.

The Use of Coffee Aroma for Stress Reduction in Postgraduate Dental Students

OBJECTIVES

This study aimed to investigate the potential reduction of academic stress related to a graded oral presentation in postgraduate dental students using coffee aromatherapy.

METHODS

Healthy postgraduate dental students in a seminar class were divided into coffee (n = 32) and control (n = 26) groups. There were 3 modes of aroma distribution: personal distribution with a coffee pad attached to a lanyard, a lanyard plus a personal fan for ventilation of the aroma, and the typical method of the diffuser to spread the aroma in the ambient air. Stress markers comprised levels of salivary alpha-amylase (sAA), cortisol (sCort), and chromogranin A (sCgA). Pulse rates were also measured.

RESULTS

Levels of sAA increased 176.62% ± 30.26% between pre- and postpresentation in the control group. Inhaling coffee aroma during the presentation period significantly ameliorated sAA increase at 81.02% ± 14.90% (P = .015). sCort levels tended to decrease in the coffee group, but not significantly. Surprisingly, sCgA levels increased more in the coffee group. Also, pulse rates decreased in the coffee group (-2.07 ± 2.81 bpm) and increased in the control group (6.90 ± 3.22 bpm; P = .035). Subgroup analysis did not reveal differences in salivary markers amongst the 3 aroma distribution modes.

CONCLUSIONS

Coffee aroma could have an anxiolytic effect on postgraduate dental students, as evidenced by changes in sAA levels and pulse rates. Personal aroma distribution was also a useful and effective mode of aromatherapy.

The effects of aromatherapy and music on pain, anxiety, and stress levels in palliative care patients

AIM

Pain and anxiety levels in palliative care patients negatively impact their quality of life, highlighting the need for research on non-pharmacological methods. This study aimed to evaluate the effects of music and aromatherapy interventions on pain, anxiety, and stress levels in these patients.

MATERIAL AND METHODS

The research was designed as a single-blind, four-group, randomized controlled trial. The sample consisted of 88 patients hospitalized in a palliative care center (receiving palliative care services with terminal or advanced diseases). Patients were randomly assigned to four groups (n = 22, music, aromatherapy, music and aromatherapy, and control group). Patients in the experimental groups received the intervention to which they were assigned for 20 min each day for three consecutive days: music, aromatherapy, or music accompanied by aromatherapy. No intervention was applied to the control group. The patients' levels of pain, anxiety, and stress were assessed before and after the intervention using the Visual Analog Scale (VAS), the Facial Anxiety Scale (FAS), and the Distress Thermometer.

RESULTS

No significant differences were found in the demographic characteristics of the groups (p > 0.05). The Wilcoxon Signed-Rank and Kruskal-Wallis tests indicated statistically significant differences in pre- and post-intervention scores for VAS, FAS, and Distress across all experimental groups on all follow-up days (p < 0.05).

CONCLUSION

Implementing music, aromatherapy, and their combination effectively reduced pain, anxiety, and stress levels in palliative care patients, suggesting these non-pharmacological interventions can improve their quality of life.

TRIAL REGISTRATION

ClinicalTrails.gov (Registration number: NCT06024954) at 05-SEP-2024.

Effects of Aromatherapy on Physical and Mental Health of Cancer Patients Undergoing Radiotherapy and/or Chemotherapy: A Meta-Analysis

BACKGROUP

Currently, aromatherapy is being increasingly utilized in clinical practice, particularly in managing the side effects associated with radiotherapy and chemoradiotherapy. However, it remains to be established whether aromatherapy can effectively alleviate these symptoms.

OBJECTIVE

To investigate the effects of aromatherapy on the physical and mental health of patients with cancer undergoing radiotherapy and chemotherapy.

METHODS

Seven databases were researched from inception until September 29, 2023, including PubMed, Scopus, and Web of Science, Chinese National Knowledge Infrastructure, Wanfang database, China Biology Medicine disc and VIP Chinese Medical Journal Database. Review Manager version 5.3 was utilized for data analysis. The Cochrane Risk of Bias tool RoB2 was employed to evaluate the quality of the literature included in the study. Evidence quality rating was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach through the GRADEpro GDT online tool.

RESULTS

Nineteen studies involving 1,541 patients were included. Aromatherapy can alleviate nausea [relative risk (RR)=0.64, 95% confidence interval (CI): 0.53 to 0.78, P<0.05, I2=46%; standardized mean difference (SMD)=-0.86, 95% CI: -1.21 to -0.51, P<0.05, I2=64%] and vomiting (RR=0.54, 95% CI: 0.42 to 0.69, P<0.05, I2=35%; SMD=-1.28, 95% CI: -1.52 to -1.03, P<0.05, I2=92%), improve sleep disorders [mean difference (MD)=-3.39, 95% CI: -3.95 to -2.84, P<0.05, I2=0%], relieve pain (SMD=-1.58, 95% CI: -1.96 to -1.21, P<0.05, I2=0%), mitigate fatigue (SMD=-1.28, 95% CI: -2.44 to -0.11, P<0.05, I2=93%) and enhance quality of life (SMD=0.50, 95% CI: 0.22 to 0.79, P<0.05, I2=0%) in cancer patients after radiotherapy and chemotherapy, but it may not have a significant effect on anxiety. The risk of bias was high in the included studies using the Cochrane Risk of Bias tool RoB2, and no studies were considered to be of high grade according to the GRADE system.

CONCLUSIONS

Aromatherapy is an efficacious, safe and economic adjunctive therapy for cancer patients, which can mend the physical symptoms and mental health of cancer patients. However, more high-quality studies are needed to verify it. (PROSPERO registration No. CRD42023390171).

Role of Creative Therapies in Gynecological Oncology: Results of a Multigenerational Survey in Patients and Caregivers

INTRODUCTION

Although creative therapies like painting, dancing, and writing are often used and encouraged to treat various diseases, including cancer, there are few systematic scientific studies on innovative therapies in medical care.

METHODS

An anonymous survey was developed for female patients, their relatives, and female medical staff on the impact of creative therapies on optimizing clinical therapy management in exclusively female trials.

RESULTS

Of 718 respondents, 358 were female patients, 69 were medical personnel, and 291 were in the control group. Overall, 91.2% of respondents had sought access to creative therapies, indicating strong self-motivated engagement in activities to improve health and well-being. This study also uncovered a significant preference for creative writing among patients. Furthermore, the data suggest that integrating innovative therapies into biopsychosocial anamnesis could offer valuable insights into patients' mobility, mood, and social behaviors. Despite a general hesitation to discuss leisure activities with medical professionals, many patients wanted to incorporate creative activities into their treatment plans. Moreover, group settings for innovative therapy were preferred, highlighting the need for more structured support in medical environments to facilitate these therapeutic interactions.

CONCLUSIONS

This study suggests creative therapies can be valuable in medical care.

Chios mastiha essential oil exhibits antihypertensive, hypolipidemic and anti-obesity effects in metabolically unhealthy adults - a randomized controlled trial

The essential oil of the resinous exudate from Pistacia lentiscus of Chios namely Chios Mastiha Essential Oil (CMEO), is a natural volatile oil rich in monoterpenes α-pinene, β-myrcene, β-pinene. In the present randomized controlled trial, we investigated the effects of CMEO on individuals with abdominal obesity and metabolic abnormalities i.e., dyslipidemia, hypertension, insulin resistance. Eligible patients (N = 94) were randomly assigned to either the intervention group, receiving capsules containing 200 mg of CMEO daily for 3 months adjunct to current treatment for metabolic disorder(s), or the control group. Anthropometric measurements, blood markers, and quality of life (QoL) were assessed. Statistical analysis was performed on an intention-to-treat basis. A significant improvement in blood lipid profile, namely triglycerides (p = 0.026) and low-density lipoprotein (p = 0.05) of the CMEO group versus controls was observed. Systolic blood pressure (p = 0.05) and alanine aminotransferase (p = 0.022) significantly decreased only after CMEO intake. Alike, weight decreased only in CMEO (p = 0.02), while mean changes in % body fat (p = 0.005) and visceral fat (p = 0.045) were significantly different between groups post-intervention. Lower oxidized LDL (p = 0.044) and higher adiponectin (p = 0.007) were recorded in CMEO with significant different mean changes between groups post-intervention. QoL, as assessed by Short Form-12 questionnaire was improved in the CMEO compared to control (p = 0.041 for Physical Composite Score, p = 0.035 for Mental Composite Score). No adverse effects were reported. An anti-obesity effect of CMEO, probably attributed to modulation of inflammatory and antioxidant processes, is suggested. Conclusively, CMEO can be safe and effective in regulating metabolic abnormalities, adjunct to treatment. (ClinicalTrials.gov. The effect of Mastiha oil in Metabolic Syndrome, ID Number: NCT04785573).