essential oils in cancer care: role of the apn

Essential Oils in Cancer Care: Role of the APNBY DEBRA REIS, MSN, RN, CNP

What Are Essential Oils?Aromatic volatile liquids

Life essence of the plant

Chemical Constituents determine purity and therapeutic value

COPYRIGHT DEBRA REIS WELLNESS SERVICES, 2019

Ways to Obtain Essential Oils

COLD EXPRESSION

Squeezing the plant material under pressure

Usually citrus oils: orange, lemon, grapefruit


Steam Distillation Process


Genuine vs Synthetic

Know your source

Know your company

Know plant and environment

Know extraction process

Know botanical precision


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


Policy and ProcedurePolicy & Procedure

Relaxation and Stress Management

Inhalation – Diffuser, Tissue, Inhaler

Topical – Dilution, Bath

Infection Control

Assessment & Documentation


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


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


Chemistry of Essential OilsChemistry of Essential Oils

Hydrocarbons – composed of H+, C+

Monoterpenes

Sesquiterpenes

Diterpenes


Chemistry of Essential OilsChemistry of Essential Oils

Oxygenated compounds

esters

aldehydes

ketones

alcohols

phenols

oxides


Harmonic ResonanceEverything in life vibrates

Orderliness in Nature

In Tune or Out of Tune


Scientific CorrelationsDr. Harry Oldfield

Looked at energy of plants organic vs pesticides

Dr. James OschmanEnergetic Pharmacology

Dr. Richard GerberSubtle Energy System


Scientific CorrelationsBarbara BrennanHands of Light

Martha RogersTheory of Unitarian Man


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


Olfaction

Limbic System

Osmobiosis – Penoel, MD


Neuroendocrine – Immune SystemsInteractions of the systems

Feedback Loops

Support Systems

**It is all Connected**


Neuroendocrine - Olfaction

Nose to Nervous System and Beyond


Paolo RevestiSmell is about Identity!

Smell is reduced in civilized societies

Indigenous societies identify each other through smell


Olfaction TheoriesShape Theory – aroma fits a shape on a protein

Vibration Theory – aroma vibrates with a frequency; Turin theory


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


Vibration Theory of Smell

LUCA TURIN – VIBRATION THEORY

Molecules have vibrations which gives odor recognition

This theory is not fully accepted


Olfaction – Application in Practice

Inhalation – on a tissue

Diffusion – water base

Inhaler/Aromastick – client home use


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


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)


Essential Oils to ConsiderLavender (Lavandula angustifolia) – calm and relaxation

Peppermint (Mentha x piperita) – awaken and aid memory

Lemon (Citrus limon) – uplifting and energizing


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.


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


Clinical Concerns - Insomnia

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)


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)


Clinical Concerns – Mood Disorders

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


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).


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


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


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


Experiential


Olfactory Receptors Sites on the Skin!!PARADIGM SHIFT

Not restricted to the nasal epithelium

Various cells in body – skin and gut

New research!


Skin’s Ability to “Smell”Opens the door to new science to validate vibrational healing!

Possible rationale for essential oils effectiveness with topical application


Olfactory Receptors (ORs) as BiomarkersSome olfactory receptors identified as biomarkers for carcinoma

Olfactory receptors activated which may lead to a reduction of cancer cells


Olfactory ReceptorsPractical Applications for Essential Oils

Wounds

Skin care

Animals


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


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


Essential Oils to ConsiderOrange (Citrus sinesis) – comfort care

Frankincense (Boswellia carteri) – immune support

Copaiba (Copaifera reticulata) – anti-inflammatory


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.


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


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


Clinical Concerns - Discomfort

•Frankincense essential oil may provide comfort due to its anti-inflammatory activity

(Price & Price, 2012)


Clinical Concern - Discomfort

Togni et al (2015) – boswellia based cream beneficial for breast cancer patients undergoing radiation treatment


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


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


Precautions with Topical Application


Safety Alert!

Essential Oils for Clinical Practice

• No medications on skin with essential oils!!!

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


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)


Essential Oils to Avoid in Cancer Care

Role of the APN


Questions


Thank You!


essential oils in cancer care: role of the apn

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