If you were to ask most people what causes cancer, the answer would probably be smoking, alcohol, the sun, hair dye or some other avoidable element.

But the most important risk factor for cancer is something else: ageing.

That’s right, the factor most associated with cancer is unavoidable – and a condition that we will all experience.

Why is this important? Older adults are the fastest-growing population in Canada and globally.

By 2068, approximately 29 per cent of Canadians will be over age 65.

With cancer being one of the most common diseases in older adults and one of the most common diseases in Canada, it means we need to think about how to provide the best cancer care for older adults.

Demographic shift

So, how are we doing so far? The answer is: not great. This may be surprising, but we also have a great opportunity to innovate and prepare for this demographic shift in cancer care.

International guidelines — including those from the American Society of Clinical Oncology — say that all older adults should have a geriatric assessment prior to making a decision about their cancer treatment. The most widely used models of geriatric assessment involve a geriatrician.

Consultation with a geriatrician for an older adult allows the oncologist and the older adult to engage in a conversation about cancer treatment, armed with information. Things like how treatment might affect their cognition, their function, their existing illnesses (which most older adults have when they are diagnosed with cancer), and the years of remaining life.

Importantly, geriatricians centre their assessment on what matters most to patients. This approach anchors any decision about cancer around the wishes of older adults and their support systems. When diagnosed with cancer, older adults undergo many tests and measures of function, but the evidence supports that these are not as accurate as geriatric assessment for identifying problems that may be below the surface.

Care in Canada

In Canada, there are currently only a handful of specialised geriatric oncology clinics. The oldest clinic is in Montréal at the Jewish General Hospital, followed closely by the Older Adult with Cancer Clinic at Princess Margaret Cancer Centre in Toronto, led by Shabbir Alibhai, one of the authors of this story. As researchers, we are in touch with clinics in Ontario and Alberta that have told us they have geriatric oncology services under development, so we hope to see new programs soon.

These clinics aren’t just good for patients. In fact, a study led by Shabbir Alibhai demonstrated a cost savings of approximately $7,000 per older adult seen in these clinics. If we map this onto the number of older adults diagnosed with cancer in Canada every year, this represents a huge cost savings for our public health system. Despite this overwhelming evidence, this is still not routine care.

In British Columbia, there are currently no specialised services for older adults with cancer. Over the last five years, Kristen Haase — also an author of this story — has been working with colleagues to understand whether these services are needed and how they could help older adults with cancer in B.C.

This work involved conversations with more than 100 members of the cancer community. The research team spoke with older adults undergoing cancer treatment, who sometimes had to relocate for cancer treatment. Other participants included caregivers who cared for elderly family members during their cancer treatment and described numerous challenges they faced, and volunteers who ran a free transportation service — a service also mostly staffed by older adult volunteers.

The research team also heard from health-care professionals: oncologists, nurses, physiotherapists and social workers. The latter group coalesced around the need for additional supports within the cancer care system so they could do their job well, and best support older adults.

The results indicate that both those working in the system and those using the system want and need better support.

Barriers to care

So, where are we now and why don’t we have these services across Canada?

Cost is obviously a barrier to any healthcare service. But with evidence that any costs will be offset by demonstrated cost savings, this is a non-starter.

Health human resources are one huge restriction. Geriatricians are in high demand and there is a low supply. However, nurse-led models have also been shown to be successful. With the expanding role of nurse practitioners across Canada, this option has huge potential to innovate care, and at a lower cost.

Another reason is good old inertia. Our clinical care model in oncology has remained mostly intact for over three decades. It is primarily a single physician-driven model. Although modern therapies for cancer have emerged at a breathtaking pace and have been introduced into clinical practice, it is much harder to change the model of care, particularly for strategies such as geriatric assessment that are harder to implement than a new drug or surgical/radiation technique.

The last, and perhaps the most difficult to pin down of all potential reasons for the absence of specialised cancer services for older adults, is agism. Ageism is discrimination based on age. It is one of the most common forms of discrimination and it is deeply embedded in many of our systems. Imagine a scenario where children diagnosed with cancer couldn’t access a paediatrician. We would collectively be outraged. Yet somehow, we accept this for older adults.

Due to the overwhelming number of older adults who are and will be diagnosed with cancer in the coming years, it will never be possible for all of them to receive specialised geriatric services. But there is an opportunity to innovate models of care that are targeted to those who need services the most: those who are most frail, are most likely to benefit from tailored care, and will reap the most benefit in terms of quality of life.

Stratifying these programs around those who need them the most will also have the greatest financial impact. And if personal stories of improving quality of life for older adults with cancer or international guidelines don’t move decision-makers, hopefully, cost savings will.

From warming winter teas to zesty stir-fries, ginger (Zingiber officinale) has long been a kitchen staple. But beyond its culinary charm, this spicy root has a rich history in traditional medicine – and modern science is catching up.

Studies now show that ginger may offer a wide range of health benefits, from easing nausea and relieving colds to reducing inflammation and supporting heart health.

Here’s what you need to know:

1. Nausea relief

Multiple clinical trials have shown consistent evidence that ginger can reduce nausea and vomiting, particularly when compared to a placebo. The NHS even recommends ginger-containing foods or teas for easing nausea.

Ginger seems especially effective for nausea during pregnancy. In small doses, it’s considered a safe and effective option for people who don’t respond well to standard anti-nausea treatments.

There’s also promising evidence that ginger can help with chemotherapy-induced nausea, though results are mixed when it comes to motion sickness and post-surgery nausea.

Researchers believe ginger’s anti-nausea effects may work by blocking serotonin receptors and acting on both the gut and brain. It may also help by reducing gas and bloating in the digestive tract.

2. Anti-inflammatory benefits

Ginger is rich in bioactive compounds, such as gingerol and shogaol, which have strong antioxidant and anti-inflammatory properties.

Recent research suggests ginger supplements may help regulate inflammation, especially in autoimmune conditions. One study found that ginger reduced the activity of neutrophils — white blood cells that often become overactive in diseases like lupus, rheumatoid arthritis and antiphospholipid syndrome.

Neutrophils produce extracellular traps (NETs), which are web-like structures used to trap and kill pathogens. But when NETs form excessively, they can fuel autoimmune diseases. In the study, taking ginger daily for one week significantly reduced NET formation.

While this study used ginger supplements, it’s unclear whether fresh ginger or tea has the same effect. Still, the findings suggest ginger may be a helpful, natural option for people with certain autoimmune conditions – though more research is needed.

Ginger also has antimicrobial properties, meaning it can help combat bacteria, viruses and other harmful microbes. Combined with its anti-inflammatory effects, this makes ginger a popular remedy for easing cold and flu symptoms like sore throats.

3. Pain management

When it comes to pain, the research on ginger is encouraging – though not conclusive. Some studies show that ginger extract can reduce knee pain and stiffness in people with osteoarthritis, especially during the early stages of treatment. However, results vary, and not everyone experiences the same level of relief.

For muscle pain, one study found that taking two grams of ginger daily for 11 days reduced soreness after exercise.

Ginger may also ease menstrual pain. In fact, some studies suggest its effectiveness rivals that of non-steroidal anti-inflammatory drugs like ibuprofen.

Researchers believe ginger works by activating pathways in the nervous system that dampen pain signals. It may also inhibit inflammatory chemicals like prostaglandins and leukotrienes.

4. Heart health and diabetes support

High blood pressure, high blood sugar and elevated “bad” cholesterol (low-density lipoprotein or LDL cholesterol) are all risk factors for heart disease. Ginger may help with all three.

A 2022 review of 26 clinical trials found that ginger supplementation can significantly improve cholesterol levels — lowering triglycerides, total cholesterol and LDL cholesterol, while raising HDL (“good”) cholesterol. It may also lower blood pressure.

For people with type 2 diabetes, ginger could offer additional benefits. A review of ten studies found that taking one to three grams of ginger daily for four to 12 weeks helped improve both cholesterol levels and blood sugar control.

These benefits appear to come from multiple mechanisms, including improved insulin sensitivity, enhanced glucose uptake in cells, and reduced oxidative stress. Ginger’s anti-inflammatory actions may also contribute to its heart-protective effects.

Some early research suggests that ginger may also offer benefits for sexual health, though evidence in humans is still limited. Animal studies have found that ginger can boost testosterone levels, improve blood flow, and enhance sexual behaviour. In traditional medicine systems, it has long been used as an aphrodisiac. While there’s not yet strong clinical evidence to confirm a direct impact on libido, ginger’s anti-inflammatory, circulatory and hormonal effects could play a supportive role, particularly for people managing conditions like diabetes or oxidative stress.

5. Brain health and cancer research

Emerging evidence suggests ginger may also offer neuroprotective and anti-cancer benefits. Lab-based studies show that ginger compounds can help protect brain cells from oxidative damage – a key factor in neurodegenerative diseases like Alzheimer’s.

Other in-vitro research has found that ginger can slow the growth of some cancer cells. However, these findings are still in early stages and more research is needed to confirm their relevance in humans.

Ginger is generally safe when consumed in food or tea. But like any supplement, it should be used in moderation.

Doses above four grams a day may cause side effects such as heartburn, bloating, diarrhoea or mouth irritation. These are usually mild and temporary.

Certain groups should use caution with high doses. Ginger may increase bleeding risk in people on blood thinners (like warfarin, aspirin or clopidogrel), and it can enhance the effects of diabetes or blood pressure medications, potentially leading to low blood sugar or blood pressure. Pregnant women should also consult a doctor before using high doses.

So ginger isn’t just a fragrant kitchen spice – it’s a natural remedy with growing scientific support. For most people, enjoying ginger in food or tea is a safe and effective way to tap into its therapeutic potential. If you’re considering taking supplements, it’s always best to speak with your doctor or pharmacist first, especially if you’re managing a medical condition or taking medication.

Microplastics are a big environmental issue. They’ve been found in oceans, drinking water, seafood, the air we breathe, and increasingly throughout the human body, from the placenta to the brain.

A new study by researchers in Italy, published in the European Heart Journal, adds another organ to that growing list: the heart’s own blood supply. But while the discovery of microplastics in coronary blood is concerning, the most intriguing finding may not be the plastics themselves. It is how they may be getting there.

Researchers found that people who smoke were six times more likely to have detectable micro- and nanoplastics in the blood supplying their hearts than non-smokers. Even more notable, every smoker who was also exposed to higher levels of air pollution had plastics detected in their blood, compared with just 12.5% of people who neither smoked nor experienced high pollution exposure. That is a remarkable difference, even in a small population.

Rather than simply confirming another harmful consequence of smoking, these findings raise an intriguing possibility: cigarettes may also act as an efficient delivery system for microscopic plastic particles. For decades we’ve understood why smoking damages the heart and blood vessels. Tobacco smoke contains thousands of chemicals that trigger inflammation, damage blood vessels, promote clotting and accelerate the build-up of fat inside arteries.

The new research suggests another mechanism could be operating alongside these well-established risks. Cigarette smoke contains enormous quantities of fine particles that penetrate deep into the lungs. The researchers propose that inhaled micro- and nanoplastics may hitch a ride with these particles, crossing the delicate air sacs of the lung, called alveoli, and entering the bloodstream far more readily than previously thought. Air pollution may facilitate a similar process.

This doesn’t necessarily mean the detected particles originated from the cigarette itself, although most cigarette filters are made from the plastic cellulose acetate and may contribute. Rather, smokers inhale air that already contains microscopic plastic particles from synthetic clothing fibres, tyre wear, degraded packaging and countless other environmental sources. Smoking may simply make it easier for these particles to cross from the lungs into the circulation.

The researchers studied 61 patients undergoing a heart test called coronary angiography. They compared three groups: people who had experienced a heart attack, patients with stable coronary artery disease and people with normal coronary arteries.

Micro- and nanoplastics were detected in 84% of patients who had suffered a heart attack compared with 40% of those with chronic coronary disease and 32% of those with normal coronary arteries. Heart attack patients also carried a greater variety of plastic polymers, with polyethylene, commonly used in packaging, being the most frequently detected.

Importantly, the researchers also observed higher levels of inflammatory markers in patients with detectable plastics. Since inflammation plays a central role in destabilising fatty blockages in the heart and triggering heart attacks, this biological link deserves further investigation.

Why this isn’t proof yet

This study, however, does not prove that microplastics cause heart attacks. The study was based on a small number of participants and was observational. That means researchers identified associations but cannot determine whether one factor caused another.

People who smoke often experience greater exposure to environmental pollution and may differ in many other lifestyle factors that influence cardiovascular risk. Patients treated for acute heart attacks receive intravenous fluids and medical devices that themselves may introduce tiny plastic particles into blood samples.

That caution matters. Microplastics have become a topic that attracts considerable public attention, and it is tempting to assume every new discovery represents proof of harm. Science rarely works that way. Instead, each study contributes another piece to a much larger puzzle.

Whether or not microplastics ultimately prove to play a direct role in heart disease, this study reinforces a broader message that has become increasingly difficult to ignore. Our heart health is shaped not only by our genes and personal lifestyle choices but also by the environments we live in.

Air pollution is already recognised as a major contributor to cardiovascular disease worldwide. Smoking remains one of the largest preventable causes of premature death. If both exposures also increase the movement of environmental plastics into the bloodstream, they may represent overlapping rather than separate risks.

This idea fits with a growing understanding of the exposome; the sum of environmental exposures we accumulate throughout life. Rather than considering tobacco smoke, air pollution and plastic pollution independently, researchers are beginning to examine how these exposures interact.

The findings should not distract from the established reasons to stop smoking. Cigarette smoking already dramatically increases the risk of heart attack, stroke, cancer and chronic lung disease.

But if future research confirms that smoking also acts as a gateway through which microscopic plastics enter the bloodstream, it would add yet another mechanism by which tobacco harms health.

The statistic likely to resonate most with readers is also the simplest: in this study, every participant who both smoked and had high air pollution exposure had detectable plastics in their blood, compared with only one in eight people exposed to neither.

This small study doesn’t prove plastics caused heart disease, but it does remind us that smoking is more than a source of toxic chemicals. It may also be helping transport another modern pollutant to places in the body we never expected to find it.