124 Aromatherapy and breast cancer on physical symptoms might also occur. Corner et al. (4) evaluated the use of massage and essential oils on the well being of cancer patients. The results showed that anxiety scores reduced significantly over time only for the essential oil massage group. Concerning effectiveness for pain, mobility, ability to work and communication with family, the essential oil group performed better than the control group. Wilkinson et al. (5) also evaluated aromatherapy massage in palliative care in a randomized control study involving full body aromatherapy massage or carrier oil massage three times a week. For the aroma group, significant improvements were found for physical, psychologic, quality of life and severe physical and psychologic subscales of the Rotterdam Symptom Checklist (RSCL), pre- to post-test. For the massage group, there were no differences in any RSCL subscales, from the pre- to post-test. For the whole group and each group, significant improvements in the State-Trait Anxiety Inventory (STAI)-state were noted pre- to post- test for each massage. Kohara et al. (6) also reported that combined modality treatment consisting of aromather- apy, soaking the feet and reflexology appears to be effective for alleviating fatigue in terminally ill cancer patients. Few studies have examined the psychologic and immunologic effects of aromatherapy on breast cancer patients. Since immunologic activity is a critical factor in determining a patient’s prognosis, it is very important to examine the effect of aromatherapy on immunologic activity. Therefore, in the present study, we examined the psychologic and immunologic parameters of aromatherapy massage for breast cancer patients. Methods Subjects This study was performed between 2003 and 2005. The subjects were selected according to the following criteria: (i) Inclusion criteria (a) patients with breast cancer (b) subjects aged 20–70-years old (c) more than 1 month after surgery, chemotherapy or irradiation (d) indifferent from stage of cancer and (e) possibility of hormonal therapy (ii) Exclusion criteria (a) patients with recurrence of cancer (b) patients with marked edema This study was conducted after obtaining approval from the Ethics Committee of Kyoto Prefectural University of Medicine. We gave detailed explanations on the project Table 1. Profile of breast cancer patients Age Stage Surgical intervention Non-surgical intervention 40–49-years old 3 I 3 BCR 8 Chemotherapy hormone 6 50–59-years old 9 IIA & B 7 4 Mastectomy Chemotherapy irradiation 1 Unknown 2 5 Hormone BCR, breast conserving surgery. to each subject and all subjects signed informed consent forms prior to participating. Fourteen patients were entered into the present study, aged 45–58 years, stage 1–4, from 6 months to over 3 years post-operation. Recurrence was observed in two patients. Therefore, these two were excluded from this study. All patients had received chemotherapy and/or hormonal treatment, although more than 1 month had passed since the completion of chemotherapy (Table 1). Study Design We designed this study as an open semi-comparative trial, which means that the 1 month period before aromatherapy massage was a waiting control period. We compared the parameters in this period with those during the aromatherapy massage sessions and 1 month after the completion of aromatherapy. Carrier Oil and Essential Oils Jojoba oil was purchased from Meadows (Canterbury, UK). Sweet orange oil (Citrus aurantium) (Lot No.LF3190567), Lavender oil (Lavandula angustifolia) (Lot No. LF3190559) and Sandalwood oil (Santalum album) (Lot No. LF3160489) were purchased from Laboratoire Sanoflore (Gigore-et-Lozeron, France). Psychologic Tests We used the Hospital Anxiety and Depression Scale (HADS) (7), STAI (8) and Profile of Mood State (POMS) (9) for evaluation of the psychologic response. The subjects filled out the forms for psychologic tests (STAI and POMS) 1 month before aromatherapy massage, immediately before and after the first, fifth and eighth massage, and 1 month after massage. The 1-month period before aromatherapy massage was designated as a waiting control period. We used State anxiety of STAI for determination of short-term effect of aromatherapy massage. We used Trait anxiety of STAI and POMS for the determination of long-term effect.