The purpose of this study is to find out if patients with prostate cancer who have vasomotor symptoms, commonly called hot flashes, from their Androgen Deprivation Therapy (ADT) will consistently wear a smartwatch device to track their health data, log hot flashes on their smartwatch, and how these data compare with daily surveys about their hot flashes. Participants will be asked to wear the smartwatch for 4 weeks and to log their hot flashes on their smart watch pressing a button on the watch. Participants will be asked to complete surveys (sent through a text message link) to describe their experiences with hot flashes.

Participants in this study will be asked to log vasomotor symptoms events (VMS or hot flashes) via a smartwatch device and record VMS frequency and subjective experiences via daily electronic surveys.

After a consent is signed and eligibility is confirmed, participants will receive an EmbracePlus (Empatica, Inc.) smartwatch, corresponding charging device, and manual. Participants will download the Empatica Care smartphone application.

The study team will verify successful pairing of the EmbracePlus smartwatch to the participant's smart phone and the collection of biometric data. The study team will instruct participants on use of the device, including instructions on logging VMS events. This orientation will occur at the University of Virginia. The smartwatches and charging devices must be returned to the study team.

Participants will then take the watch home and be asked to continuously wear their EmbracePlus smartwatch (with the exception of time needed to charge the device) for the duration of the study.

Participants will be asked to log VMS event by pressing a designated button on the smartwatch device for one second, once at the beginning and once at the conclusion of an event.

Data will be transmitted via Bluetooth connection from the EmbracePlus smartwatch to the Empatica Care smartphone application. Data will then be transferred from the app to the Empatica Cloud server, where the research team will access and monitor the data. The Empatica Health Monitoring Platform received initial FDA clearance in 2022.

Participants will receive electronic EMAs from the UVA Qualtrics platform up to 4 times per day, for 28 days.

Participants will receive a check-in call and an end of study survey.

Inclusion Criteria:

1. Provision of signed and dated informed consent form

2. Stated willingness to comply with all study procedures and availability for the duration of the study

3. Male (biologic sex), aged ≥18 years of age

4. Diagnosis of prostate cancer

5. Must be receiving active treatment with ADT at the time of enrollment

   a. ADT is defined as any medical or surgical intervention intended to lower the serum testosterone to <50 mg/dL for the purpose of treating prostate cancer

6. Evidence of castrate level testosterone by either of the following:

   1. A documented serum testosterone level of <50 ng/dL at any time point since initiation of ADT or
   2. A documented decrease in PSA following initiation of ADT and no evidence of PSA progression per PCWG3 criteria (PSA progression defined as a rise in PSA of ≥25% from PSA nadir and absolute increase of ≥1 ng/mL confirmed by a second measurement at least 3 weeks later)

7. Duration of ADT expected to extend for a minimum of 4 weeks from time of study enrollment

8. Report experiencing VMS that began after initiation of ADT and occur with a minimum frequency of once per day

9. Own a smartphone with Bluetooth 5 compatibility and be willing to use cellular data and/or Wi-Fi on their smartphone. Participants must agree to download the Empatica Care app on their smartphone.

   1. iPhone 8 or higher with iOS 16.0 or higher
   2. Android devices version 12, 12.1, 13, 14, 15, or higher

10. Ability to read, speak, and understand English

11. ECOG performance status of 0, 1, or 2

Exclusion Criteria:

1. Wrist circumference less than 95 mm or greater than 222 mm
2. Known allergic reactions to components of the EmbracePlus smart watch, specifically any skin allergy to silicone
3. Presence of VMS prior to initiation of ADT, regardless of severity or duration
4. Active febrile illness (temperature >38°C) or on active treatment for febrile illness
5. Inability to press button on smart watch crown
6. Those receiving any experimental therapy for treatment of their prostate cancer (other standard of care prostate cancer therapies are permitted)
7. Evidence of progression of prostate cancer as defined by PCWG3 criteria