Topical Frankincense Did Not Relieve Chemotherapy-Related Fatigue

By Dustin Samples - May 22, 2023

A recent study published in Cancer Nursing found no evidence of reduced fatigue in patients who applied a topical dilution before, during, and after chemotherapy regimens.

Many patients report moderate-to-severe cancer-related fatigue. Although the only remedies proven efficacious are exercise and education, there are many reports of holistic approaches to fatigue relief, including the use of essential oils. Many oils, such as lavender, ginger, and mandarin, are reported to improve cancer-related symptoms when diffused and inhaled, such as stress, fatigue, and sleep quality. Others, such as peppermint, chamomile, and coconut, have been used in topical forms with similar results.

In a randomized controlled trial at the ProMedica Cancer Institute, Flower Hospital, Toledo, Ohio, researchers sought to determine whether a dilution of frankincense (5% in jojoba carrier oil, 5 ml)­—anecdotally reported to reduce cancer-related symptoms—applied directly to the soles of patients’ feet would positively affect self-reported fatigue scores.

Patients (N=70) with varying types and stages of cancer scheduled to receive at least 3 rounds of chemotherapy were randomized at 1:1 to a control group (jojoba oil alone) and a treatment group (jojoba oil with 5% frankincense). There were no noted differences between the 2 groups in demographics, except for the control group having a slightly higher percentage of patients with advanced education beyond high school. There were also no noted differences between the groups in health status. Most patients were classified as anemic and either overweight or obese.

Patients were instructed to apply 2 drops of oil to the bottom of each foot twice per day 2 days before chemotherapy, during chemotherapy, and 2 days after chemotherapy. Most patients had 1-day treatments, though some had up to 5-day treatments. All were treated as outpatients. Patients were screened at baseline, during therapy, and 2 days after treatment using the Functional Assessment of Chronic Illness Therapy—Fatigue (FACIT-F) scale (version 4) to measure fatigue and the Hospital Anxiety and Depression Scale (HADS) to measure psychological distress. They also kept daily compliance journals.

Though all patients reported lower fatigue at the end of the study, no difference was attributed to the use of frankincense. This could be due to several confounding factors, such as differences in the duration of treatment, disease stage, or concurrent therapies. In addition, the control oil was odorless, while the treatment oil had a slight scent. While participants were not advised of the difference, some in the control group may have associated the lack of scent with lack of treatment, or vice versa.

“Our null findings in light of the number of anecdotal reports of frankincense reducing symptoms…are puzzling,” wrote the authors, though they did feel the report had value for nurses. “Nurses can educate patients that although the effectiveness of relieving fatigue with frankincense was not demonstrated in this study, the risk of harm was minimal and manageable.”


Cancer-related fatigue: a pilot study evaluating the effect of frankincense essential oil in patients with cancer receiving chemotherapy