Effectiveness of Aromatherapy with Light Thai Massage for Cellular Immunity Improvement in Colorectal Cancer Patients Receiving Chemotherapy

  • Khiewkhern, Santisith (Department of Epidemiology, Faculty of Associated Medical Sciences, Khon Kaen University) ;
  • Promthet, Supannee (Department of Epidemiology, Faculty of Associated Medical Sciences, Khon Kaen University) ;
  • Sukprasert, Aemkhea (Hemato-oncology Unit, Department of Medicine, Faculty of Medicine, Faculty of Associated Medical Sciences, Khon Kaen University) ;
  • Eunhpinitpong, Wichai (Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University) ;
  • Bradshaw, Peter (Faculty of Public Health, Faculty of Associated Medical Sciences, Khon Kaen University)
  • Published : 2013.06.30


Background: Patients with colorectal cancer are usually treated with chemotherapy, which reduces the number of blood cells, especially white blood cells, and consequently increases the risk of infections. Some research studies have reported that aromatherapy massage affects the immune system and improves immune function by, for example, increasing the numbers of natural killer cells and peripheral blood lymphocytes. However, there has been no report of any study which provided good evidence as to whether aromatherapy with Thai massage could improve the immune system in patients with colorectal cancer. The objectives of this study were to determine whether the use of aromatherapy with light Thai massage in patients with colorectal cancer, who have received chemotherapy, can result in improvement of the cellular immunity and reduce the severity of the common symptoms of side effects. Materials and Methods: Sixty-six patients with colorectal cancer in Phichit Hospital, Thailand, were enrolled in a single-blind, randomised-controlled trial. The intervention consisted of three massage sessions with ginger and coconut oil over a 1-week period. The control group received standard supportive care only. Assessments were conducted at pre-assessment and at the end of one week of massage or standard care. Changes from pre-assessment to the end of treatment were measured in terms of white blood cells, neutrophils, lymphocytes, CD4 and CD8 cells and the CD4/CD8 ratio and also the severity of self-rated symptom scores. Results: The main finding was that after adjusting for pre-assessment values the mean lymphocyte count at the post-assessment was significantly higher (P=0.04) in the treatment group than in the controls. The size of this difference suggested that aromatherapy with Thai massage could boost lymphocyte numbers by 11%. The secondary outcomes were that at the post assessment the symptom severity scores for fatigue, presenting symptom, pain and stress were significantly lower in the massage group than in the standard care controls. Conclusions: Aromatherapy with light Thai massage can be beneficial for the immune systems of cancer patients who are undergoing chemotherapy by increasing the number of lymphocytes and can help to reduce the severity of common symptoms.


  1. Bernstein BJ, Grasso T (2001). Prevalence of complementary and alternative medicine use in cancer patients. Oncology, 15, 1267-72.
  2. Billhult A, Bergbom I, Stener-Victorin E (2007). Massage relieves nausea in women with breast cancer who are undergoing chemotherapy. J Altern Complement Med, 13, 53-7.
  3. Billhult A, Lindholm C, Gunnarsson R, Sterner-Victorin E (2008). The effect of massage on cellular immunity, endocrine and psychological factors in women with breast cancer-a randomized controlled clinical trial. Auton Neurosci, 140, 88-95.
  4. Billhult A, Stener-Victorin E, Bergbom I (2007). The experience of massage during chemotherapy treatment in breast cancer patients. Clin Nurs Res, 16, 85-99.
  5. Buckle J (2001). The role of aromatherapy in nursing care. Nurs Clin North Am, 36, 57-72.
  6. Cassileth BR, Vickers AJ (2004). Massage therapy for symptom control: outcome study at a major cancer center. J Pain Symptom Manage, 28, 244-9.
  7. Chang SY (2008). Effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. Taehan Kanho Hakhoe Chi, 38, 493-502.
  8. Corbin, L (2005). Safety and efficacy of massage therapy for patients with cancer. Cancer Control, 12, 158-64.
  9. Diego MA, Field T, Hernandez-Reif M, et al (2001). HIV adolescents show improved immune function following massage therapy. Intern J Neuroscience, 106, 35-45
  10. Field T, Cullen C, Diego M, et al (2001). Leukemia immune changes following massagetherapy. J Bodywork and Movement Therapies, 5, 271-4.
  11. Hernandez-Reif M, Field T, Ironson G, et al (2005). Natural killer cells and lymphocytes increase in women with cancer following massage therapy. Int J Neurosci, 115, 495-510.
  12. Hernandez-Reif M, Ironson G, Field T, et al (2004). Breast cancer patients have improved immune and neuroendocrine functions following massage therapy. J Psychosomatic Res, 57, 45-52.
  13. Imanishi J, Kuriyama H, Shigemori I, et al (2009). Anxiolytic effect of fect of aromatherapy massage in patients with breast cancer. Evid Based Complement Alternat Med, 6, 123-8.
  14. Ironson G, Field T, Scafidi F, et al (1996). Massage therapy is associated with enhancement of the immune system’s cytotoxic capacity. Int J Neurosci, 84, 205-17.
  15. Lai TK, Cheung MC, Lo CK, et al (2011). Effectiveness of aroma massage on advanced cancer patients with constipation: a pilot study. Complement Ther Clin Pract, 17, 37-43.
  16. Kuriyama H, Watanabe S, Nakaya T, et al (2005). Immunological and psychological benefits of aromatherapy massage. Evid Based Complement Alternat Med, 2, 179-84.
  17. Lundie S (1994). Introducing and applying aromatherapy within the NHS. The Aromatherapist, 2, 20-35.
  18. Molassiotis A, Fernadez-Ortega P, Pud D, et al (2005). Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol, 16, 655-63.
  19. Rees R, Feigel I, Vickers AJ, et al (2000). Prevalence of complementary therapy use by women with breast cancer. A population-based survey. Eur J Cancer, 36, 1359-64.
  20. Serfaty M, Wilkinson S, Freeman C, Mannix K, King M (2012). 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, 563-9.
  21. Wilkinson S, Barnes K, Storey L (2008). Massage for symptom relief in patients with cancer. Systematic review. J Adv Nur, 63, 430-9.
  22. Wright D (1999). Home massage for hospice patients. Nurs Spectr, 9, 7.

Cited by

  1. Prognostic Significance of Beclin-1 Expression in Colorectal Cancer: a Meta-analysis vol.15, pp.11, 2014,
  2. Putting Evidence Into Practice: An Update of Evidence-Based Interventions for Cancer-Related Fatigue During and Following Treatment vol.18, pp.s6, 2014,
  3. Effects of Aromatherapy Massage on Pregnant Women's Stress and Immune Function: A Longitudinal, Prospective, Randomized Controlled Trial vol.23, pp.10, 2017,
  4. Acute Oral Toxicity Test of Chamaecyparis obtusa Essential Oil on ICR Mice vol.33, pp.3, 2018,
  5. Effect of Aromatherapy Massage on Chemotherapy-Induced Peripheral Neuropathic Pain and Fatigue in Patients Receiving Oxaliplatin vol.42, pp.2, 2019,