eCAM 2009;6(1) 127 Figure 2. Immunologic effects of aromatherapy massage on breast cancer patients. Peripheral blood was drawn 1 month before aromatherapy massage, immediately before the first, fifth and eighth massage, and 1 month after massage. And blood cell counts including numbers and proportions of leukocytes were examined. Lymphocyte subsets were identified by FACS analysis. *P50.05, NS: not significant. On the other hand, trait anxiety using STAI and HADS, which are appropriate for the determination of long-term effects, gradually reduced over the sessions. That is, there was a significant decrease in trait anxiety scores between 1 month before and after massage., HADS also showed that the anxiety gradually reduced over time, while there were no significant differences in the depression scores. Coinciding with our results, Corner et al. (4) also reported that aromatherapy massage significantly reduced anxiety. Although other investiga- tions (10–13) did not find that aromatherapy had an anxiolytic effect in patients with cancer, we found that aromatherapy massage had both short- and long-term effects on anxiety reduction in breast cancer patients. Immunologic, CD16-positive lymphocytes (natural killer cells) were reduced significantly after aromatherapy massage and there was a significant difference between the numbers immediately before the first and eighth massage. However, CD4-CXCR3-positive lymphocytes (type 1 helper T cells) increased significantly after the eighth aromatherapy massage, as compared with before the eighth massage. CD4-CCR4-positive lymphocytes (type 2 helper T cells) also increased significantly by aromatherapy sessions. Although it is hard to interpret these results theoretically, it is possible that aromather- apy massage affects the immune system. In our previous study of healthy subjects, CD8-positive and CD16- positive lymphocytes increased significantly after a 30 min aromatherapy session (1). The behavior of CD16-positive lymphocytes, however, was different from that of this investigation and we are as yet unable to explain this difference. No significant changes in the waiting control period and significant decreases of anxiety both in the short- term and long-term show that aromatherapy massage holds promise as an effective therapy for breast cancer patients. Further investigations with an increased sample size and improved study design, including a control group, are required to confirm our results. To do this, it will be important to find a therapy suitable for the control. Outside psychologic therapies, anxiolytic drugs and anti-depressants, conventional medicine offers no effective interventions to reduce anxiety concerning recurrence and/or metastasis. Our results suggest that aromatherapy massage is a viable complementary therapy that significantly reduces anxiety in breast cancer patients.