A study that was stopped before it reached its conclusion offered preliminary results supporting the use of aromatherapy massage for reducing anxiety among patients at the end of life. 

“Results of a pilot study of the Four Counties randomized controlled trial to evaluate the effectiveness of aromatherapy massage with 1 % Santalum album (Sandalwood) (group A) when compared with massage with Sweet Almond Carrier oil, (group B) or Sandalwood oil via an aroma-stone (group C), in reducing levels of anxiety in palliative care,” was conducted over more than two years, stopping in 2004 due to a higher-than-anticipated attrition rate among study participants.

Palliative-care patients, or those with a life-threatening illness that no longer responds to treatment, often experience anxiety; 25 to 35 percent of cancer patients experience depression. The study examined the effectiveness of an essential oil on the symptom of anxiety among these patients.

The study was conducted over four weeks, with interventions provided once per week. A starting number of 80 pilot-study participants were randomized into three groups: Group A received a 20-minute leg-and-foot massage using sandalwood oil mixed into sweet almond carrier oil; Group B received the same massage using only the carrier oil; and Group C experienced sandalwood oil via an aroma-stone for 20 minutes. Each group was given five minutes of rest after the treatment, and five minutes to complete study questionnaires. The same music was played during the sessions for all three groups.

The treatments were provided in patient homes, outpatient aromatherapy clinics, and in palliative day-care and in-house units throughout Oxfordshire, Berkshire, Buckinghamshire and Hertfordshire counties, England, by aromatherapists.

Study participants provided self-reports of anxiety before and after each intervention using a visual analog scale (VAS). Additional self-reports using the State-Trait Anxiety Inventory were administered at the beginning of the trial and at the end. This tool measured changes in anxiety and determined whether there was an accumulative effect over the four-week period.

Because of a high attrition rate (60 percent over two years), due to increased severity of illness symptoms, hospital admission or death, the study was halted in 2004, with just 34 completed interventions. Though incomplete, the study revealed some preliminary findings: groups A and C showed the most sustained drop in anxiety level in the VAS scores, while Group B showed the least change in anxiety. Groups A and C also showed steady decline in anxiety level over the four-week period. 

 “The results seem to support the notion that massage with sandalwood oil was the most effective and sustained treatment for reducing anxiety, especially when compared with group B that had less convincing results. This was further reinforced by the results generated by group C, which were better than those of group B, suggesting that sandalwood essential oil might be the key,” writes study author Gaye Kyle, a senior lecturer at Thames Valley University in Slough, England.

However, Kyle writes, “the sample size of 34 was too small to distribute all confounding factors equally between the groups thereby canceling out any differential effect they may have had on the outcome.”

She concludes, “The results of the pilot study were encouraging and support the view that sandalwood essential oil may have sustained effect in reducing anxiety.”

This study first appeared in Complementary Therapy Clinical Practice, 2006 May; 12 (2): 148-55.

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