Princess Health and Ashland hospital expands into wellness and prevention programs. Princessiccia

Princess Health and Ashland hospital expands into wellness and prevention programs. Princessiccia

diabetes employers health insurance hospitals jobs physical activity prevention wellness

Gusty 06:12 Add Comment

By Judi Kanne
Kentucky Health News

Hospitals� basic business is taking care of the sick and injured, not keeping people from getting sick. But more and more of them are getting into wellness and prevention, not only to help their communities but to make money.

King's Daughters Heart and Vascular Center

One of those is King�s Daughters Medical Center in Ashland, which has developed an innovative strategy for building relationships with local employers to help their employees live healthier lives.

King�s Daughters began by focusing on self-insured employers, who can get the most direct benefit from reduced health-care expenses. It used one-to-one employer outreach activities such as a farm-to-table employer lunch, to which more than 126 local employers were invited.

The first question for employers, said Matt Ebaugh, vice president and chief strategy officer at King�s Daughters, is �Do you understand what is driving the cost for your employees?� because �Self-funded employers do not always have the analytics or tools needed to understand where those costs come from.�

King�s Daughters used Strategic Health Services of Alpharetta, Ga., to create a portal for health risk assessment, biometric screening results, claims analytics and personal health profiles of employees.

While the program is aimed at wellness, it also finds new cases for the hospital. �We knew if we did a smart thing for local employers, demonstrated value, and coupled it with good customer service, then when employees needed a higher level of care, they would come to us,� Ebaugh said.

By means of screenings for diabetes, cholesterol, and body mass index, employees become patients.

Diabetes screening can be critical. About 86 million American adults are pre-diabetic, but nine out of 10 people who are don�t know it, according to the federal Centers for Disease Control and Prevention. That can be detected with health-risk assessment lifestyle questionnaires.

Beyond individual screenings, hospitals can examine the emerging risks in a population using claims data. That can also help them show employers what�s driving up their costs. Claims also indicate which employees are most likely to use hospital and pharmacy services.

�We need to find innovative ways to motivate individuals to change old and dangerous patterns,� Ebaugh said, because simple lifestyle changes can dramatically cut the risk for developing diabetes.

But getting healthy may require offering financial and other incentives to get people to participate in wellness programs. The Ashland hospital plans to try gamification, incorporating into the workday a set of programmed games and activities that remind sedentary employees to get up, stretch, and move around.

The idea is to make health and fitness fun, a social experience and accessible to as many members as possible. Gamification programs include computer notifications or other reminders that stimulate sedentary disruption and track activity. In some cases, motivation includes team competition in which employees win points by stopping to stretch.

Ebaugh said such programs have been shown to work and are critical in some cases, because a pre-diabetic employee may not be motivated enough to change eating and exercise patterns. �Knowing is not enough,� he said. �We anticipate the energy and participation with gamification will increase as a result of more engaging activities.�

The hospital first started a wellness program for its own employees, and plans to add gamification to it, Ebaugh said: �It�s important our model work well to show our employers the success we are having with our internal employees.�

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.

Princess Health and 1/2 of cancer deaths and maybe 1/2 of new cases could be prevented by exercise, watching food and drink, and not smoking. Princessiccia

Princess Health and 1/2 of cancer deaths and maybe 1/2 of new cases could be prevented by exercise, watching food and drink, and not smoking. Princessiccia

cancer obesity prevention research smoking tobacco tobacco prevention

Gusty 08:31 Add Comment

Half of all cancer deaths could be prevented "by applying insights that we've had for decades � no smoking, drinking in moderation, maintaining a healthy body weight and exercising," Carolyn Y. Johnson reports for The Washington Post, about a study published in JAMA Oncology.

Those measures could also cut new cancer cases by 40 to 60 percent. Those are big numbers, and especially important for Kentucky, which has some of the nation's leading rates of cancer and death from it � and, not coincidentally, is among the national leaders in smoking and obesity.

"Some of the declines we have already seen in cancer mortality � the large decline in lung cancer � that was because of efforts to stop people from smoking," Siobhan Sutcliffe, an associate professor in the division of public health sciences at Washington University in St. Louis, told Johnson. "Even while we�re making new discoveries, that shouldn�t stop us from acting on the knowledge we already do have."

Sutcliffe was not involved in the study, which used "large ongoing studies that have closely followed the health and lifestyle habits of tens of thousands of female nurses and male health professionals," Johnson reports. "They divided people into two groups: a low-risk group that did not smoke, drank no more than one drink a day for women or two for men, maintained a certain healthy body mass index, and did two-and-a-half hours of moderate aerobic exercise a week or half as much vigorous exercise.

"The team compared cancer cases and cancer deaths between the low- and high-risk groups and found that for individual cancers, the healthy behaviors could have a large effect on some cancers: The vast majority of cases of lung cancer were attributable to lifestyle, as well as more than a fifth of cases of colon cancer, pancreatic cancer and kidney cancer.

"Then, they extrapolated those differences to the U.S. population at large, finding an even larger proportion of potentially preventable cancer cases and deaths. For women, they estimated 41 percent of cancer cases were preventable and 59 percent of cancer deaths. For men, 63 percent of cancer cases were potentially preventable and 67 percent of deaths."

The researchers at Massachusetts General Hospital and the Harvard T.H. Chan School of Public Health noted some caveats: "The high-risk group in the study is healthier than the general U.S. population, so there are reasons the numbers may be slightly overestimated," Johnson writes. "But Mingyang Song, the researcher who led the work, argues the numbers are a good approximation because they may be underestimating the effects of lifestyle, too, because they selected a narrow range of lifestyle factors."

Princess Health and Kentucky Center for Economic Policy report warns about impact of Bevin's proposed Medicaid changes. Princessiccia

Princess Health and Kentucky Center for Economic Policy report warns about impact of Bevin's proposed Medicaid changes. Princessiccia

economy federal spending health reform jobs Medicaid obamacare Patient Protection and Affordable Health Care Act politics prevention state budget state government

Gusty 13:15 Add Comment

By Danielle Ray

Kentucky Health News

A research group with a liberal outlook warned Monday that Republican Gov. Matt Bevin should be careful in changing the state Medicaid program.

The Kentucky Center for Economic Policy said the state�s expansion of Medicaid eligibility under Democratic Gov. Steve Beshear has increased health screenings and job growth in health care.

Tobacco counseling and interventions increased 169 percent from 2013 to 2014, the first year of the expansion, the report noted. Influenza vaccinations went up 143 percent and breast cancer screenings increased 111 percent, it noted.

In addition, Medicaid expansion brought Kentucky health-care providers nearly $3 billion through mid-2015 and resulted in a 4.6 percent job growth in the health-care sector from 2014 to 2016, according to the report.

�No matter how you look at Medicaid expansion in Kentucky, it�s clear it has had a positive effect on access to health care that will improve our state�s economy and quality of life,� Jason Bailey, executive director of KCEP, said in a news release.

However, Bevin says the state can�t afford to have more than a fourth of its population on Medicaid and is seeking a waiver from the federal government to make changes in the program, such as �skin in the game� for beneficiaries: co-payments, deductibles or health savings accounts, as used in a year-old experiment in Indiana, which he has cited as an example.

The KCEP reports says the Medicaid waiver Bevin is seeking could result in additional costs to recipients and benefit changes. Arkansas was the first state to design a Medicaid expansion using such a waiver. So far, five other states have implemented similar waiver-based programs.

Waiver programs differ from standard Medicaid expansion in that they utilize some or all of the following: health savings accounts, a cost-sharing account to be used for health care expenses; lockouts, periods in which recipients who have been dis-enrolled for failure to pay premiums are barred from re-enrolling; and premium assistance, the use of Medicaid funds to buy private insurance plans.

These waivers are designed to grant states the freedom to enact experimental programs within Medicaid, so long as the programs continue to reflect the overall goal of Medicaid, increasing coverage of low-income individuals and improving overall health care, as well as efficiency and stability of health care programs that serve that population.

The Foundation for a Healthy Kentucky, which convened a meeting of Medicaid stakeholders last week, is holding off on making judgments of the proposed waiver program. �We believe that diverse input is essential to sustaining these gains, and to continue improving our health care system and health outcomes in Kentucky,� said Susan Zepeda, president of the foundation.

Zepeda said research the foundation has funded has shown a greater decrease in the number of Kentuckians who lack health insurance than any other state, which she attributes largely to Medicaid expansion adding about 400,000 Kentuckians to the rolls.

More than 1.4 million Kentuckians are enrolled in Medicaid, 39 percent of whom are children. Nearly 32 percent are enrolled under the expansion: childless adults in households that earn less than 138 percent of the federal poverty line, currently $33,000 for a family of four.

The KCEP report also asserts that Kentucky�s Medicaid benefits are on par with those of other states, specifically that 12 out of 13 of Kentucky�s optional benefits are also covered in at least 40 other states and territories. Kentucky Medicaid only covers services that are deemed medically necessary.

KCEP noted that Medicaid is a partnership in which the federal government funds a minimum of half of traditional Medicaid spending in each state, with poorer states receiving a larger federal match. In Kentucky, the federal share is about 70 percent. For people covered by the expansion, the federal government is paying the full cost through this year, but the state will pay 5 percent in 2017, rising in annual steps to the law�s limit of 10 percent in 2020.

The full KCEP report is at http://kypolicy.org.

Princess Health and Ky. has plan to keep Zika virus out of state, but needs your help; travelers to Zika-affected areas need to take precautions. Princessiccia

Princess Health and Ky. has plan to keep Zika virus out of state, but needs your help; travelers to Zika-affected areas need to take precautions. Princessiccia

birth defects mosquitoes pregnancy prevention public health

Gusty 10:53 Add Comment

By Melissa Patrick
Kentucky Health News

State officials launched a mosquito prevention campaign May 9 at the Kentucky State University Research Farm near Frankfort as part of the state's efforts to combat the Zika virus, with an emphasis on the need for Kentuckians to do their part at home and when they travel.

"Zika prevention is mosquito prevention," Health Secretary Vickie Yates Brown Glisson said at the news conference where she introduced the campaign, "Fight the Bite Day and Night."

To date, six cases of Zika have been confirmed in Kentucky, all in people who were infected abroad and then returned to the U.S. But Glisson said it is "very possible" that Kentucky could have a local outbreak because the state has the species of mosquito that transmits the virus.

Of the 59 mosquito species in Kentucky, only one, Aedes aegypti, a small, black mosquito that bites mostly during the day, has been confirmed as a Zika carrier, and it is "very rare," accounting for "roughly one out of every 5,000 or so mosquitoes that we catch here in Kentucky," said Grayson Brown, director of the Public Health Entomology Laboratory at the University of Kentucky. However, Brown said six or seven other species in the state could be Zika transmitters, including the state's most common monquito, Aedes albopictus, better known as the Asian tiger mosquito.

The major concern is that a Zika-infected person will return to the U.S., get bitten by a mosquito that can transmit it to the next person it bites, with the cycle continuing.

Symptoms of the virus include fever, rash, joint pain and red eyes, although about 80 percent of people who are infected with the Zika virus never show symptoms.

Those in greatest danger from the infection are women in early pregnancy. Infants born to Zika infected mothers are at high risk for microcephaly, a condition where the infants head is smaller than normal, as well as other possible severe fetal brain defects. It has also been associated with Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks its nerves, in adults. The World Health Organization has declared Zika an international health threat.

Dr. Ardis Hoven, infectious disease specialist with the Kentucky Department of Public Health, urged travelers to protect themselves from mosquitoes by using EPA-approved repellents and wearing protective clothing while in affected areas, and doing so for three weeks after returning home to prevent transmission to local mosquitoes.

"If everyone does this, it greatly reduces the risk of Zika ever getting into Kentucky's mosquito population," said Hoven, who is also chair of the World Medical Association. "We are counting on you, so please take this advice seriously."

The state has created an extensive action plan to monitor Zika infected mothers and their infants that includes a monitoring schedule, and access to many social and healthcare services as needed. The state health department has reported that one of the confirmed Zika cases in the state is a pregnant woman.

Hoven advised pregnant women to not travel at all to affected areas and specifically said, "Pregnant women should not attend the Olympics," which will be held in Rio de Janeiro in August.

Concerns about Zika in Rio prompted Amir Attaran, a professor in the School of Public Health and the School of Law at the University of Ottawa, to write a commentary for the Harvard Public Health Review, calling for the Olympic Games to either be postponed or moved to another country.

"Does it really make sense to send a half-million [Olympic tourists] into Rio, which is, to be very clear, not the fringes of the outbreak? It's the heart of the outbreak," Attaran told NPR. "But is it at the end of the day sensible to run the risk of a global epidemic of, let's face it, brain-damaged babies, when that could be avoided by simply postponing the games or moving them elsewhere?"

Attaran, whose wife is from Brazil, told NPR that while the risk is quite low for individual athletes or individual tourists, "when you multiply (that) by 500,000, the odds are extremely high that somebody will take the disease elsewhere and seed a new outbreak."

Zika can also be transmitted sexually, which has occurred about 10 times now in the United States, Hoven said.

Shelley Wood, nurse consultant for Zika at the state health department, said male travelers without symptoms should use condoms for eight weeks after departure from a Zika-affected area. Men with Zika symptoms should get tested and use condoms for six months, and male travelers with pregnant partners should wear condoms throughout the pregnancy .

Wood also said couples should take steps to prevent conception for at least eight weeks after returning from a Zika-affected area, and women should not travel to such areas eight weeks before they are trying to conceive.

State officials urged Kentuckians to be vigilant about mosquito control and reminded them to remember the "3 D" approach to decrease the risk of infection by mosquitoes:

• Drain all standing water where mosquitoes breed such as bird baths, tires, buckets and gutters
• Defend against mosquitoes with approved insect repellents at all times for outdoor activities.
• Dress in light colored long sleeved shirts and pants.

State Agriculture Commissioner Ryan Quarles announced a partnership between his Agriculture Department and the health ahency as part of its Zika prevention plan. This partnership allows health officials to mobilize "strike teams" and use Agriculture Department equipment if the state begins to have local transmissions of Zika. Typically, the Agriculture Department sprays for mosquitoes at the request of local officials or local health departments.

Hoven said, "As with all public health issues, the best form of protection is prevention, not clean-up."

The University of Kentucky College of Agriculture website has the latest updates on Zika and its spread.

Princess Health and Study shows uninsured rate keeps falling, preventive services are popular and rural hospitals have more uncompensated care. Princessiccia

Princess Health and Study shows uninsured rate keeps falling, preventive services are popular and rural hospitals have more uncompensated care. Princessiccia

Foundation for a Healthy Kentucky health care access health insurance insurance coverage Kynect Medicaid prevention research

Gusty 13:54 Add Comment

By Melissa Patrick
Kentucky Health News

The share of Kentuckians without health insurance continues to drop, and new Medicaid enrollees continue to take advantage of free preventive health services, according to an ongoing study of federal health reform's impact in the state.

The Foundation for a Health Kentucky is paying the State Health Access Data Assistance Center at the University of Minnesota more than $280,000 for a three-year study of how the Patient Protection and Affordable Care Act is affecting Kentuckians.

The report found that the rate of people without health insurance in Kentucky continues to drop.

In December 2015, the uninsured rate was 7.5 percent, down from 9 percent in June 2015. The national rate in December was 11.7 percent. In 2013, before the implementation of the PPACA, Kentucky's uninsured rate was 20.4 percent.

Since December 2013, Kentucky's uninsured rate has dropped 12.9 percentage points, more than double the national decline of 5.6 percentage points, says the report. Uninsurance rates can vary depending on how they are measured. This study used data from the Gallup-Healthways Well-Being Index, which produces state-level estimates of coverage twice a year.

"Lack of insurance is a significant barrier to getting necessary health care and preventive services timely," Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, said in a news release. "Tracking this and other key information about access to and cost of care in Kentucky helps to inform health policy decisions."

Kentucky also continues to have a lower uninsured rate than its eight nearest surrounding states, although Ohio (7.6 percent) and West Virginia (7.7 percent) are catching up. Missouri (11.6 percent), Tennessee (13 percent) and Virginia (12.6 percent), the three states surrounding Kentucky that did not expand Medicaid, have the highest uninsured rates. (SHADAC map)

And while the state saw a smaller share of new health-insurance customers than the country overall (20 percent versus 39 percent), Kentucky had the largest percentage of re-enrollees (59 percent) return to Kynect, the state's health insurance marketplace, to select plans compared to the rest of the nation (36 percent). Twenty-two percent of Kentuckians were automatically re-enrolled in plans.

Kynect, created by the Democratic administration of Steve Beshear, is in the process of being dismantled by the administration of Republican Gov. Matt Bevin, so Kentuckians will have to sign up for their health insurance through the federal exchange, healthcare.gov, during the next enrollment period which begins Nov. 1, 2016 and runs through Jan. 31, 2017.

Traditional Medicaid enrollees will sign up through Benefind, the state's new one-stop-shop website that can be used to apply for Medicaid, the Kentucky Children's Health Insurance Program (KCHIP), the Supplemental Nutrition Assistance Program (SNAP, once known as food stamps) and Kentucky Transitional Assistance Program (KTAP).

Expansion of Medicaid added about 400,000 Kentuckians to the program, and many of them have taken advantage of its free services to get screened for diseases and have physical or dental examinations.

Dark blue: traditional Medicaid enrollees
Light blue: Medicaid expansion enrollees

The latest report, which covers the fourth quarter of 2015, says 823 traditional Medicaid enrollees got screened for diabetes, compared to 2,959 Medicaid expansion enrollees. This was also true for colorectal screenings (see graph).

Overall, the study found that Medicaid covered 41,493 dental preventive services, 9,708 breast cancer screenings, 8,276 substance-abuse treatment services, and 5,589 colorectal-cancer screenings to enrollees aged 19-64.

Under federal health reform, Beshear expanded Medicaid to include those with incomes up to 138 percent of the federal poverty level. The federal government pays for this expanded population through this year, but next year the state will be responsible for 5 percent of the expansion, rising in annual steps to the reform law's limit of 10 percent in 2020.

However, the future of the expansion is uncertain. Bevin has said that the state cannot afford its Medicaid population of about 1.3 million, and has charged his administration with designing a new Medicaid program, which will require federal government approval. He told reporters in early May that he was optimistic that the Centers for Medicare and Medicaid Services will approve the state's new plan, but if they don't it will be because "CMS does not want to see expanded Medicaid continue in Kentucky."

The study found that Medicaid enrollment continues to be the highest in Eastern Kentucky with 31 percent participation, followed by Western Kentucky at 26 percent participation.

It also notes that while levels of uncompensated care have dropped for both urban and rural hospitals since 2013, rural hospitals saw slight increases in uncompensated care in 2015. (SHADAC graphic)

For the full report, click here.

Princess Health and Zika update: Local anti-mosquito action needed; McConnell, Rogers at center of debate over Obama's request for more funds. Princessiccia

Princess Health and Zika update: Local anti-mosquito action needed; McConnell, Rogers at center of debate over Obama's request for more funds. Princessiccia

birth defects Congress federal spending mosquitoes pregnancy prevention public health virus

Gusty 17:14 Add Comment

Mosquitoes can carry Zika. (NPR photo)

By Melissa Patrick
Kentucky Health News

While all 388 Zika virus cases confirmed in the continental U.S., including six in Kentucky, have been in people who were infected abroad and then returned to the states, a health official said on "Fox News Sunday" that it is likely the U.S. will have its own outbreak.

"It is likely we will have what is called a local outbreak," said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, Diane Bartz reports for Reuters.

Fauci said he did not expect a large number of people to become ill: "We're talking about scores of cases, dozens of cases, at most."

Dr. Ardis Hoven, infectious disease specialist for the Kentucky Department for Public Health, agreed and said the potential exists for Kentucky to have a local outbreak.

"I think it would be unreasonable for us to assume that we would not be at risk," she said in a telephone interview. "So therefore, we have to plan accordingly."

Hoven said mosquito control in the state is a "top priority," but said the bulk of this will have to happen at a local level.

She encouraged Kentuckians to talk about mosquito prevention with their friends and family and ask themselves, "What can I do in my community, in my yard, on my street to prevent mosquitoes from hatching and infecting those around me?"

Zika virus prevention strategy: Dress, Defend and Drain

The state has adopted a "3 D" approach to decrease the risk of infection by mosquitoes: Dress in light-colored long sleeved shirts and pants; Defend against mosquitoes with approved insect repellents; and Drain all standing water.

"If we can control mosquitoes in our region, we will go a long way to minimize the potential risk from infected mosquitoes," Hoven said.

The World Health Organization declared Zika a global health emergency in February. Those who have traveled to affected areas, such as Central and South America, are at the highest risk of contracting the virus, which is spread primarily by infected Aedes aegypti mosquito. It can also be spread through sexual intercourse. Aedes aegypti can be found in about 30 U.S. states, including Kentucky.

Zika virus is especially dangerous to pregnant women because it has been linked to thousands of cases of microcephaly, a condition where the infants head is smaller than normal, as well as other severe fetal brain defects, according to the federal Centers for Disease Control and Prevention. The state health department has reported that one of the confirmed Zika cases in the state is a pregnant woman.

The CDC is investigating the link between Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks its nerves. And Fauci said there could be other neurological conditions caused by Zika that affect adults, Bartz reports.

"There are only individual case reports of significant neurological damage to people, not just the fetuses, but an adult that would get infected. Things that they call meningoencephalitis, which is an inflammation of the brain and the covering around the brain, spinal cord damage due to what we call myelitis," Fauci said. "So far they look unusual, but at least we've seen them and that's concerning."

Common symptoms of the virus are fever, rash, joint pain and red eyes, with symptoms lasting for about a week, though many with the virus have no symptoms. Currently there is no vaccine for Zika.

Funding to fight Zika held up in Congress

In February, President Obama asked Congress for an additional $1.9 billion in emergency funds to fight the Zika virus, including funds to develop a vaccine. This is in addition to $589 million in previously appropriated funds that have already been transferred to the effort.

That money should last through Sept. 30, the end of the federal fiscal year, but "There's going to need to be additional money, I don't think there's any doubt about that," Rep. Tom Cole, R-Okla., who chairs the House health appropriations subcommittee, told Susan Cornwell of Reuters April 13.

Top senators from both parties said "they are getting close to a deal to provide at least some emergency funding to fight the Zika virus, making it likely that the Senate will move ahead on the issue without waiting for the House," David Nather writes for STAT, an online health journal.

Senate Majority Leader Mitch McConnell, R-Ky., said at a news conference April 19 that congressional Republicans were working with the administration on the funding details, Peter Sullivan reports for The Hill.

�We're working with them on it to figure out exactly the right amount of money,� McConnell said at a press conference. �You know, how is it going to be spent? And I don't think, in the end, there will be any opposition to addressing what we think is going to be a fairly significant public health crisis."

Nevertheless, House Republicans kept saying they don't have enough information to approve the request.

On April 20, House Appropriations Committee Chairman Hal Rogers, R-Ky., said the Obama administration �continues to delay response efforts by refusing to provide basic budgetary information to Congress on their Zika funding request. This includes not answering our most basic question: �What is needed, right now, over the next 5 months in fiscal year 2016, to fight this disease?� In the absence of this information, the House Appropriations Committee will work with our colleagues in the House and the Senate to make our own determinations on what is needed and when, and to provide the funding that we believe is necessary and responsible.�

Five days earlier, White House Press Secretary Josh Earnest said Republicans have all the information they need to move forward, ABC reports. He said, �They've had ample opportunity to collect information, to ask questions of senior administration officials, to read letters, to read the legislative proposal that was put forward by the administration.� 

Princess Health and Exercise can help prevent or slow cancer, study suggests. Princessiccia

Princess Health and Exercise can help prevent or slow cancer, study suggests. Princessiccia

cancer exercise prevention research

Gusty 02:43 Add Comment

Exercise may keep you from getting cancer and slow the growth of a tumor if you get one, according to a mouse-based study published in the journal Cell Metabolism by researchers at the University of Copenhagen in Denmark.

They report that training mice regularly on a wheel (the mouse version of a treadmill) decreased the growth of multiple types of tumors, including skin, liver, and lung cancers. Also, mice that exercised regularly had a smaller chance of developing cancer in the first place, and less cancer-associated weight loss.

The researchers linked the anti-cancer effects to the release of adrenaline (also called epinephrine), a hormone central to the mammalian �fight-or-flight� response. Exercise stimulates the production of adrenaline, which mobilizes immune cells, including one called a "natural killer." NK cells are recruited to the site of the tumor by the protein IL-6, which is secreted by active muscles. NK cells can then infiltrate the tumor, slowing or completely preventing its growth.

The researchers pointed out that injecting the mice with adrenaline or IL-6 without the exercise was not sufficient to inhibit cancer development, showing that regular exercise was needed to activate the hormone and the protein.