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Antibacterial Essential Oils Reduce Tumor Smell and Inflammation in Cancer Patients

University of Kiel, Kiel, Germany

Eugene Sherry

University of Sydney, Sydney, Australia

Paul A.J. Russo

The Canberra Hospital, Canberra, Australia

Martin Sprengel

Municipal Hospital Flensburg, Flensburg, Germany

Yahya Açil

University of Kiel, Kiel, Germany

Joachim P. Bredee

University of Kiel, Kiel, Germany

Sabine Schubert

University of Kiel, Kiel, Germany

Jorg Wiltfang

University of Kiel, Kiel, Germany

Ingo N. Springer

University of Kiel, Kiel, Germany

To the Editor:

Tumor necrosis with associated malodor in cancer patients is a serious problem in oncology and palliative care throughout the world.¹ Necrotic neoplastic ulcers are usually superinfected with anaerobic bacteria such as Bacteroides, Enterobacter, or Escherichia coli species,² especially when the ulcers communicate with the oral or nasal cavity. Patients suffering from tumor malodor suffer the additional stress of both perceived and real social isolation in the hospital wards and in the community as a result of their smell.

In an attempt to address this problem, we have been conducting a pilot study in the use of topically applied essential oils. Essential oils such as tea tree and eucalyptus oils have recently gained acceptance as safe and effective antiseptics.³ Their potent bactericidal activity has already been proven in in vitro and clinical trials.^4-8

We have previously reported that the elimination of tumor-related malodor is possible with an essential oil mixture, the application of which led to an improved quality of life for our cancer patients.⁹ We are now able to report that we have observed an additional beneficial effect of the topical application of essential oils in patients with head and neck tumor–related ulcers: they promote ulcer healing and re-epithelization.

A 67-year-old man presented with an extremely large and inoperable squamous cell cancer of the left buccal mucosa that had eroded through to the extraoral skin, resulting in a fistula. Having previously declined surgery, radiotherapy, and chemotherapy, his reason for presenting was the foul smell emanating from the ulcer. This was a result of a suppurative superinfection. Our approach to management was two-fold: In addition to a 5-day course of oral clindamycin (600 mg twice daily), the fistula was rinsed twice a day with 5 mL of a Eucalyptus-based oil mixture (KielMix-PT 70; Klonemax, Central Tilba, Australia). After 3 days, the patient’s malodour had completely resolved. The patient was discharged home after 14 days. Oil therapy was continued postdischarge, and administered daily by his wife, a former nurse. After 2 and a half weeks, clinical signs of superinfection in terms of inflammation and purulence were markedly reduced. The fistula appeared clean, and there was evidence of healing by secondary intention: a layer of fibrin had formed, deep in the fistula. After 6 weeks of the essential oil regimen and no further antibiotics, the fistula had completely closed. This is not the usual course of events for ulcers associated with cancers of the head and neck. The oil therapy did not retard the growth of the tumor, and by the eighth week it had grown along the path of the former fistula to the skin surface. Despite this, the offensive smell that had prompted his presentation to the emergency department did not recur. His quality of life had been improved by the use of the essential oils, and he was able to live at home with his family for the next 10 weeks until he died.

We have now treated more than 30 patients with a similar regimen of topical essential oils. Adverse effects are uncommon and are usually limited to minor irritation at the time of application. The beneficial effects, however, have been quite pronounced. We are in the process of planning a randomized controlled trial to confirm our observations.

Authors’ Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCES

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2. Kuge S, Tokuda Y, Ohta M, et al: Use of metronidazole gel to control malodor in advanced and recurrent breast cancer. Jpn J Clin Oncol 26:207-210, 1996[Abstract/Free Full Text]

3. Cox SD, Mann CM, Markham JL, et al: The mode of antimicrobial action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol 88:170-175, 2000[CrossRef][Medline]

4. Allen P: Tea tree oil: The science behind the antimicrobial hype. Lancet 358:1245, 2001

5. Harkenthal M, Reichling J, et al: Comparative study on the in vitro antibacterial activity of Australian tea tree oil, cajuput oil, niaouli oil, manuka oil, kanuka oil and eucalyptus oil. Pharmazie 54:460-463, 1999[Medline]

6. Cox SD, Gustafson JE, Mann CM, et al: Tea tree oil causes K⁺ leakage and inhibits respiration in Escherichia coli. Lett Appl Microbiol 26:355-358, 1998[CrossRef][Medline]

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9. Warnke PH, Terheyden H, Acil Y, et al: Tumor smell reduction with antibacterial essential oils. Cancer 100:879-880, 2004[Medline]

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				C. F. Carson, K. A. Hammer, and T. V. Riley Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties Clin. Microbiol. Rev., January 1, 2006; 19(1): 50 - 62. [Abstract] [Full Text] [PDF]

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