When cancer strikes the hypothalamus in the brain of a child or adolescent, the chances of survival are excellent, thanks to modern treatment. Afterward, they can be left with a faulty hypothalamus, the part of the brain that produces hormones to regulate body temperature, hunger, and mood. With no cure available, these cancer survivors must learn to live with the condition and control their bodies and their impulses themselves. For younger patients and their families, this can be very challenging. To make things easier for them, TU/e researchers are developing a smart device to help monitor their bodies and improve their quality of life.
Children and young adults with a brain tumor in the hypothalamus have an excellent chance of surviving the disease. However, after appropriate treatment, they will be left with a hypothalamus that functions badly.
By producing key hormones, the hypothalamus regulates many bodily functions such as our day-night rhythm, body temperature, and water and fat balance. The absence of a solid connection between the hypothalamus and other brain areas can also affect our behavior and emotional balance. At this moment in time, there is currently no known cure.
Living with a faulty hypothalamus
Nowadays, adults dealing with this condition can benefit from lifestyle advice, apps, and other self-regulation techniques. Young adults and children, however, need a '24/7 buddy' to monitor them. Most often, this is done by the parents, but there is a limit to their presence and watchfulness.
With this in mind, oncologist Hanneke van Santen at the Princess Máxima Centre contacted TU/e Industrial Design researcher Yuan Lu to explore how a smart device could improve the quality of life for families. The KWF Dutch Cancer Society funds their joint research project. Added to that, it is one of the seven projects chosen in 2024 to benefit from the Fight Cancer campaign.
Passionate view
A project to help young individuals with a malfunctioning hypothalamus and their families could benefit many. Yuan Lu, an associate professor of Systemic Change and Director of Education at the Department of Industrial Design, plays a key role in the project and was very open to the project proposal when approached.
"When Hanneke van Santen of Princess Máxima Centre for Pediatric Oncology contacted me with the request to develop a smart device to help young patients suffering from a chronic affliction, I was, of course, intrigued and glad to set up the research project with her. It's a problem that needs an urgent solution," says the researcher.
Smart watch for hormonal balance after brain tumor
Children with a tumor near the hypothalamus, the hormone center in the brain, often have a very good survival rate. Yet the quality of life after treatment is often poor due to hormone imbalances. These (former) patients experience disturbed feelings of hunger and thirst, heat regulation, and day-night rhythms.
As a result, severe obesity can occur, or chronic fatigue, headaches, and somberness. Dr. Hanneke van Santen, in collaboration with TU/e and Corsano Health, wants to develop a smartwatch that can work as a kind of 'external hypothalamus'.
In this video (in Dutch), she explains why this is so important.
When starting the project, Lu and her colleagues understood that their pursuit of a solution would be limited, given the requirements for performing clinical research studies.
Lu: "We knew we would first look at existing, tested, and approved technologies ready to use. Corsano Health is a Dutch company involved in the project as the wearable device partner, bringing the technology and a robust platform for collection of medically certified physiological parameters. Hanneke already teamed up with them when initiating the project idea and this helped us to focus our search."
In addition, the group of patients with this condition is also not very large from a commercial viewpoint. That makes developing an entirely new device too costly. As a result, they opted to turn to existing technology as a foundation for their research.
Continuous challenges
PhD researcher Yu Zhang joined this research project at the end of 2023 under the supervision of Yuan Lu, Panos Markopoulos (TU/e ID), and Hanneke van Santen. He set about getting to know his research topic with an extensive literature study.
"It was immediately clear that sodium levels in the blood are a critical factor to be monitored continuously to keep track of one's fluid balance," he explains.
"The fluid balance between water and electrolytes (such as sodium) is important to keep the body functioning optimally and to prevent dehydration or its direct opposite: water intoxication. So, the sodium level was the first key parameter I wanted to incorporate in the smart device."
An alternative to sweat
One of the first things that comes to mind when considering a smartwatch is that it could be suited to measure chemicals on the skin's surface, such as in sweat. But, for Zhang, this idea was the first big disappointment in the project.
"Unfortunately, the sodium level in your sweat does not have a strong enough correlation with the sodium level in your blood to be effectively used for this group of patients," Zhang explains.
"The fluid that does bear a strong correlation is the liquid between the cells in your body. This is called the interstitial fluid. To ensure that monitoring is as minimally invasive as possible, we want to measure that fluid just one millimeter below the skin's surface."
"I will be looking into new and novel ways of measuring sodium levels in interstitial fluids because I have not encountered a standard method."
Minimally invasive monitoring
The reason that Zhang must turn to non-invasive or minimally invasive methods is that young patients have often experienced many invasive or painful procedures on the road to recovery. Therefore, it is imperative that the continuous monitoring, which they may rely on for their life-long care, is as comfortable and easy to wear and use as possible.
Zhang: "I'm inspired by the devices (ports) for continuous glucose measurements (CGM). Small devices that can be applied to the arm or stomach of diabetes patients to monitor their glucose levels. The results can be checked with a smartphone app. These devices eliminate the need for finger pricks to draw blood to measure glucose levels several times daily."
"I will explore this type of device as a potential solution, but I also have some surprising alternatives in mind." With his research in its early stages, we'll have to wait until he is a bit further down the research road to see which design might be the winning avenue of approach.
Yuan adds: "We have several different goals in the project and hope these produce interesting results and connect us to new technical partners to help us develop our ideas further. I'm already impressed with the work done by Zhang so far, and I'm curious to see where this research may take us."
Swim to Fight Cancer Eindhoven
It is exceptional to have a TU/e-led project selected by KWF as one of the seven projects to receive funding from the Fight Cancer campaign. "We are thrilled about this unique honor," says Lu.
As part of the efforts to raise further funding, KWF is organizing the Swim to Fight Cancer in Eindhoven, which will take place on June 29th at the IJzeren Man and happens to be located across the road from the TU/e campus.
"Unfortunately, we're not strong swimmers ourselves," says Lu with a smile. "But we applaud everyone who'll swim, run, or perform other activities to support KWF research this year. And thank you to everyone for helping to raise funding for such a great cause."
