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Essential Oils in Cancer Care: Role of the APNBY DEBRA REIS, MSN, RN, CNP
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What Are Essential Oils?Aromatic volatile liquids
Life essence of the plant
Chemical Constituents determine purity and therapeutic value
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Ways to Obtain Essential Oils
COLD EXPRESSION
Squeezing the plant material under pressure
Usually citrus oils: orange, lemon, grapefruit
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Steam Distillation Process
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Genuine vs Synthetic
Know your source
Know your company
Know plant and environment
Know extraction process
Know botanical precision
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100% Synthetic or Nature-identical oils •Goes into hair & skin products
Pure & Unadulterated•Safe for internal use
Natural Oils •Can still have chemicals
Synthetic plus Natural•Contains chemicals & solvents
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Policy and ProcedurePolicy & Procedure
Relaxation and Stress Management
Inhalation – Diffuser, Tissue, Inhaler
Topical – Dilution, Bath
Infection Control
Assessment & Documentation
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Safe Use of Essential Oils
CAUTION
1. Dilution in water is not recommended
2. Contact with mucous membranes or sensitive skin areas not recommended◦ skin test
◦ use soles of feet
3. People who have allergies or breathing difficulties
4. Some oils are light sensitizing; avoid sun exposure
5. Oils rich in phenols
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Safe Use of Essential Oils
CAUTION
Keep out of the reach of children and pets
Seek qualified health professional when using essential oils internally
Always have vegetable based oil available
Check for standards
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Chemistry of Essential OilsChemistry of Essential Oils
Hydrocarbons – composed of H+, C+
Monoterpenes
Sesquiterpenes
Diterpenes
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Chemistry of Essential OilsChemistry of Essential Oils
Oxygenated compounds
esters
aldehydes
ketones
alcohols
phenols
oxides
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Harmonic ResonanceEverything in life vibrates
Orderliness in Nature
In Tune or Out of Tune
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Scientific CorrelationsDr. Harry Oldfield
Looked at energy of plants organic vs pesticides
Dr. James OschmanEnergetic Pharmacology
Dr. Richard GerberSubtle Energy System
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Scientific CorrelationsBarbara BrennanHands of Light
Martha RogersTheory of Unitarian Man
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Essential Oils with Treatment
Rationale to Use Essential Oils◦Support immune system
◦ Improve energy
◦Provide comfort
◦Giraud-Roberts, MD (2009) –aromatherapy can aid quality of life and limit side effects
◦Payne (2014) – stress can promote cancer progression and possible initiation
◦Reis & Jones (2017) – Aromatherapy as a supportive treatment for cancer patients
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Olfaction
Limbic System
Osmobiosis – Penoel, MD
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Neuroendocrine – Immune SystemsInteractions of the systems
Feedback Loops
Support Systems
**It is all Connected**
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Neuroendocrine - Olfaction
Nose to Nervous System and Beyond
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Paolo RevestiSmell is about Identity!
Smell is reduced in civilized societies
Indigenous societies identify each other through smell
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Olfaction TheoriesShape Theory – aroma fits a shape on a protein
Vibration Theory – aroma vibrates with a frequency; Turin theory
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Smell ReceptorsLINDA BUCK
1991 research discovered smell receptors.
Led to revival of smell research
347 smell receptors – led to challenges with “lock and key” theory
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Vibration Theory of Smell
LUCA TURIN – VIBRATION THEORY
Molecules have vibrations which gives odor recognition
This theory is not fully accepted
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Olfaction – Application in Practice
Inhalation – on a tissue
Diffusion – water base
Inhaler/Aromastick – client home use
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Olfaction – Application in PracticeHow are essential Oils used?
Inhalation
quick action within secondsbest for clinical setting
use on tissue, inhaler, diffuser
Safety - respiratory conditions such as asthma
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Olfaction – Application in PracticeDiffusion – microdroplets allow for better absorption
Water base
Heat or Cool source
Atomizer
Diffusion helpful for prevention of airborne bacteria (Stafford, 2010)
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Essential Oils to ConsiderLavender (Lavandula angustifolia) – calm and relaxation
Peppermint (Mentha x piperita) – awaken and aid memory
Lemon (Citrus limon) – uplifting and energizing
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Lavender (Lavandula angustifolia)
Key constituents: Linalyl acetate, linalol, Perillylalcohol
Main effects: Balancing, relieves tension, relieves discomfort, relaxing
Safety data: Non-toxic, non-irritating, and non-sensitizing. Often adulterated.
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Dyer et al (2016) – blends chosen by patients
Dyer et al (2014) – most common reason for relaxation and decrease nausea
Goepfert et al (2017) – Lavender decreased vital patients regardless of consciousness
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Clinical Concerns - Insomnia
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Clinical Concerns - FatigueResearch
Lavender added to a foot soak along with reflexology showed a relief of fatigue with 20 terminally ill cancer patients (Kohara et al, Journal of Palliative Medicine, 2004)
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Lavender (Lavendula angustifolia Mill) – studied with 20 healthy adults for effect on the autonomic nervous system
Measurements - blood pressure, heart rate, respiratory rate and skin temp
Inhalation of Lavender full strength or diluted gave a relaxing effect on the body versus almond oil alone. (Sayorwan et al, 2012)
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Clinical Concerns – Mood Disorders
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Rosemary (Rosmarinus officinalis)Key Constituents: a-pinene, cineole
Main Effects: stimulating, enhances mental clarity, promotes digestion
Safety: non-toxic, non-irritating.
Frequently adulterated –know company
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Clinical Concerns - Fatigue Healthy subjects showed significant
increases in blood pressure, heart rate,
and respiratory rate after inhalation of
Rosemary essential oil.
Subjects reported feeling “fresher” after
inhaling Rosemary essential oil (Sayowan et al, 2013).
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Peppermint (Mentha x piperita)Key constituents: Menthol
Main effects: stimulating, strengthening
Safety data: non-toxic, avoid contact with face, mucosa, and eyes; not to be used with children under 30 months
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Clinical Concern – Nausea & Vomiting
Lua & Zakaria (2012) - Review 5 studies using essential oils via inhalation reported positive benefits with Peppermint and Ginger for nausea and vomiting (only one study specific to cancer patients from Stringer & Donald with aromasticks, 2011)
•Sites, D et al (2014) – relief of nausea with controlled breathing and peppermint
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Ginger (Zingerber officinalis)Clinical Concern – Nausea & Vomiting
Konmu et al (2017) – significant changes in quality of life, fatigue and reducing emesis
Lua et al (2015) – nausea score lower with inhaled ginger
Sanaati et al (2016) – ginger capsule may decrease frequency of chemo related nausea
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Experiential
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Olfactory Receptors Sites on the Skin!!PARADIGM SHIFT
Not restricted to the nasal epithelium
Various cells in body – skin and gut
New research!
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Skin’s Ability to “Smell”Opens the door to new science to validate vibrational healing!
Possible rationale for essential oils effectiveness with topical application
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Olfactory Receptors (ORs) as BiomarkersSome olfactory receptors identified as biomarkers for carcinoma
Olfactory receptors activated which may lead to a reduction of cancer cells
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Olfactory ReceptorsPractical Applications for Essential Oils
Wounds
Skin care
Animals
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How are Essential Oils Used?EXTERNAL APPLICATION
Dilute in a carrier oil especially in clinical settings
Up to 5% dilution with adults for skin application
Children, elderly, frail: Dilute 0.5%
Massage may be effective for relaxation and pain relief
INTERNAL APPLICATION
Seek qualified practitioner
Safety and education necessary
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Carrier OilsJojoba: Wax, closest preparation to our skin oil, long shelf life
Coconut: Good for skin conditions
Grapeseed: Short shelf life
Sesame Seed: Decrease inflammation
Sweet Almond: Relieve itching, long shelf life
Olive: Very emollient, long shelf life
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Essential Oils to ConsiderOrange (Citrus sinesis) – comfort care
Frankincense (Boswellia carteri) – immune support
Copaiba (Copaifera reticulata) – anti-inflammatory
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Orange (Citrus sinensis)
Key constituents: Limonene
Main effects: relaxant, stimulates circulatory system, studied for anti-tumoral effects.
Safety data: non-toxic, non-irritant. Phototoxic oil and caution with skin application.
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Copaiba (Copaifera reticulata)Key Constituents: Beta caryophyllene – 55%
Main Effects: aid digestion and support he body’s natural response to injury or irritation; animal study by Guimaraes-Santos et al(2012) suggests neuroprotection by modulating inflammatory response after acute damage
Safety: Non-toxic
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Frankincense (Boswellia Carteri)Key constituents: a-Pinene
Main effects: Supports the immune system, may stimulate the limbic system, tested for anti-tumoral action
Safety data: non-toxic, non-irritating; endangered in some areas
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Clinical Concerns - Discomfort
•Frankincense essential oil may provide comfort due to its anti-inflammatory activity
(Price & Price, 2012)
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Clinical Concern - Discomfort
Togni et al (2015) – boswellia based cream beneficial for breast cancer patients undergoing radiation treatment
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Clinical Concerns - Fatigue
Reis & Jones (2018) – case study with Frankincense 5% dilution for chemotherapy related fatigue
Pilot study (2018) – use of Frankincense topical for chemotherapy related fatigue
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Safety ConsiderationsInhalation – consider breathing conditions such as asthma and bronchitis. Essential oils may be irritating to mucosa.
Allergies and/or toxicities – skin test essential oils and carrier oils
Topical application – use soles of the feet
Internal use – seek qualified professional
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Precautions with Topical Application
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Safety Alert!
Essential Oils for Clinical Practice
• No medications on skin with essential oils!!!
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Safety Considerations in Practice
Pregnant women – consult professional
Children – consult professional; dilutions are even smaller
Epilepsy – avoid essential oils high in ketones
Cancer – avoid essential oils that have estrogen like activity
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Aniseed (Pimpinella anisum)
Star anise (Illicium verum)
Bitter Fennel (Foeniculum vulgare var. amara)
Sweet Fennel (Foeniculum vulgare var. dulce)
Myrtle (Myrtus communis)
Clary sage (Salvia sclarea)
(Buckle, 2015)
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Essential Oils to Avoid in Cancer Care
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Role of the APN
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Questions
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Thank You!
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