Simply spending time in nature shows benefits both for body terrain factors linked to cancer and for reducing cancer risk. It may also help with symptoms common among people with cancer.

How can time in nature help me? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Learn more about how we research and rate therapies and practices.

Optimizing your body terrain

Does time in nature promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

Immune function

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better immune function among adults and/or children with greater exposure to natural environments

Inflammation

Preliminary evidence of less inflammation among people ranging from healthy young adults to elderly adults with chronic obstructive pulmonary disease (COPD) or hypertension participating in forest bathing

Your microbiome

Preliminary evidence of health-promoting changes in skin and gut microbiota among urban daycare children with greater exposure to nature

Managing side effects and promoting wellness

Is time in nature linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Anxiety

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety among people with cancer in an educational facility with outlooks on natural scenery

Quality of life

Preliminary evidence of better wellness and spiritual sense among people spending time in nature or listening to nature sounds

Sleep disturbance

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep efficiencythe ratio of total sleep time to time in bed and sleep time among people with gastrointestinal tract cancer participating in forest therapy

Time in nature as part of a combination therapy

Time in nature with adventure social support: weak evidence of better quality of life among people with cancer participating in time in nature with social support

Time in nature with horticultural therapy, yoga meditation, and support group therapy: weak evidence of lower cancer-associated fatigue, and better quality of life, functional well-being, and spiritual well-being among people with cancer participating in forest therapy, horticultural therapy, yoga meditation, and support group therapy

Symptoms not specific to cancer
Anxiety

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower anxiety among people participating in forest bathing or spending time in a forest

Modest evidence of less anxiety and agitation among people without cancer in critical care listening to recordings of nature-based sounds

Cardiovascular symptoms

Modest evidence of lower blood pressure or heart rate among people with more exposure to nature

Preliminary evidence of lower blood pressure among people without cancer on mechanical ventilator support listening to recordings of nature-based sounds

Cognitive difficulties

Modest evidence of better cognitive performance among people listening to nature-based sounds

Depression or mood

Modest evidence of better mood among people listening to nature-based sounds

Preliminary evidence of lower risk of depression among people with more day-to-day exposure to nature (green spacegeographical areas characterized by higher levels of vegetation, especially compared to environments built by humans and characterized by concrete, asphalt, and other surfaces not occurring in nature)

Preliminary evidence of lower depression scores among people participating in forest therapy

Pain

Modest evidence of less pain among people listening to recordings of nature-based sounds

Quality of life, health and well-being

Modest evidence of better reported health and well-being among people with exposure to nature

Sleep disruption

Preliminary evidence of better sleep quality and quantity among people with more exposure to nature (green space)

Stress

Modest evidence of lower risk of stress-related disorders among people with dense vegetation near their residences

Modest evidence of less stress and annoyance among people listening to nature-based sounds

Other symptoms and side effects

Recovery from surgery: preliminary evidence of shorter hospital stays after surgery, better evaluations, and less analgesic use among people in hospital rooms with a view of natural scenes

Time in nature in combination with other therapies

Time in nature (outdoor walking) with light exposure and several vitamins: preliminary evidence of higher measures of overall mood, self-esteem, and general sense of well-being and fewer symptoms on two measures of depression among women with symptoms of mild to moderate depression not taking any mood-altering medication and treated with a brisk 20-minute outdoor walk, increased light exposure throughout the day, and a vitamin regimen

Reducing cancer risk

Is time in nature linked to lower risks of developing cancer or of recurrence? We present the evidence.

See also studies finding higher risk of cancer among people living closer to green spacegeographical areas characterized by higher levels of vegetation, especially compared to environments built by humans and characterized by concrete, asphalt, and other surfaces not occurring in nature, especially agricultural green space, in Safety and precautions

Cancer as a whole

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cancer mortality over 8 years among women living near higher levels of vegetation

Breast cancer

Modest evidence of lower risk of breast cancer among people living in urban areas close to green space

Leukemia

Modest evidence of lower risk of childhood leukemia among children living in a large urban area within 250 m of an urban parks or urban wooded areas

Prostate cancer

Modest evidence of lower risk of prostate cancer among people with higher levels of residential greenness

Resources

Keep reading about time in nature or forest bathing

Authors

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Maria Williams

Research and Communications Consultant
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Maria Williams is a research and communications consultant who brings over 15 years’ experience in research, consumer education, and science communication to CancerChoices. She has worked primarily in public health and environmental health.

Maria Williams Research and Communications Consultant

Reviewer

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Last update: October 10, 2022

Last full literature review: April 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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