Why we did this

About 1 man in 8 will be diagnosed with prostate cancer. According to the American Society of Clinical Oncology, 96 percent of men who are diagnosed with local or regional prostate cancer will live 15 years or more. Hot flashes are a common side effect of hormone therapy for prostate cancer that negatively impacts prostate cancer survivorship. Hot flashes impair sleep, cause physical and mental distress, and reduce quality of life. Despite the negative impact, there are few treatments for hot flashes. Most patients continue to use traditional cooling strategies (eg, fans, ice water, dressing in layers) for hot flash management, indicating a need for additional management options.

The Embr Wave wristband is a thermal device that applies cooling to the inside of the wrist and has been shown to improve hot flash control and sleep in midlife women. We evaluated if prostate cancer survivors with bothersome hot flashes would wear and use the thermal device and whether device usage resulted in improvements in the management of hot flashes and sleep.

What we did

The study was conducted virtually during the Covid pandemic and participants were recruited from prostate cancer support groups (ANCAN, ZERO, USTOO). Eligible individuals had a history of prostate cancer and bothersome hot flashes. Participants were asked to use the Embr Wave as needed for the management of hot flashes for 4 weeks. Study assessments were collected remotely and included measures of hot flash interference, sleep, subjective hot flash measures, and device satisfaction. We enrolled 57 individuals in the United States in 2021. Of these, 44 completed the 4-week study as well as all study assessments.

What we found

On average, participants used the thermal device 7.6 times a day for a total of 3.2 hours a day. At Week 4 of the study, improvements were observed in the Hot Flash Related Daily Interference Scale, which assesses the impact of hot flashes on quality of life. We also observed reduced sleep disturbance and improved daytime functioning. Two thirds of participants rated the thermal device as somewhat to extremely effective at helping them manage daytime and nighttime hot flashes. Our results support the feasibility of using the thermal device for management of bothersome hot flashes in prostate cancer survivors.

 Why it matters

Supportive hot flash management, such as using fans or dressing in layers, remains insufficient for many patients. Although estrogen treatment may reduce the incidence of hot flashes and night sweats, estrogen-related side effects (eg, gynecomastia, increased risk of thrombosis) limit the uptake of this approach. Use of a thermal device may provide a nonpharmacological management option for bothersome hot flashes due to the minimal side effect burden.

Our study results indicate that many prostate cancer survivors found it acceptable to use the thermal device for hot flash management. Improvements in hot flash measures and sleep were consistent with the known impact of hot flashes.

Optimizing hot flash management is a critical component of prostate cancer survivorship. This study illustrates the potential positive impact of a novel digital health tools to achieve this goal. Low-risk, easy to use, cooling interventions such as the Embr Wave may offer promise in this population. Future research efforts should evaluate and optimize these tools for patient engagement and efficacy.