Low Blood Pressure in Prostate Cancer: Should You Be Concerned?

Low blood pressure (hypotension) can happen for many reasons in people with prostate cancer, but it is usually related to medications, dehydration, or procedures rather than the cancer itself. Most prostate cancer therapies are more commonly linked to high blood pressure, not low blood pressure. [PM10] [PM11] That said, certain drugs for urinary symptoms (like alpha‑blockers) and some infusions or surgical settings can lower blood pressure and cause dizziness or fainting. ^{[1] [2] [3] [4]} [PM7] [PM9]

---

What “Low Blood Pressure” Means

Low blood pressure generally refers to readings below about 90/60 mmHg, but what matters most are symptoms like dizziness, lightheadedness, fainting, fatigue, blurred vision, nausea, or confusion. If you feel faint or dizzy especially when standing your blood pressure may be too low for you, even if numbers don’t look extreme. ^{[1] [2] [3] [4]}

---

How Prostate Cancer Care Can Affect Blood Pressure

• Hormonal therapies are more often associated with high blood pressure. Treatments such as abiraterone or enzalutamide commonly raise blood pressure, so teams monitor and manage hypertension. [PM10] [PM11] ^{[5] [6]}
  If you’re on these medicines and have low blood pressure, other causes (dehydration, other drugs) may be more likely. [PM10] [PM11]

• Alpha‑blockers used for urinary symptoms (e.g., doxazosin) can lower blood pressure. They may cause dizziness, lightheadedness, or fainting, especially after starting or dose changes; clinicians screen for prostate cancer while prescribing and monitor blood pressure. ^{[1] [2] [3] [4]}
  If you take doxazosin or similar drugs and feel dizzy, your dose may need adjustment or timing changes. ^{[1] [2] [3] [4]}

• Procedures and surgery can involve controlled low blood pressure. During radical prostatectomy, anesthetic strategies may deliberately lower blood pressure to reduce blood loss; blood pressure is closely monitored by the surgical team. [PM7] [PM9]
  Outside of the operating room, persistent low blood pressure with symptoms deserves evaluation. [PM9]

---

When Low Blood Pressure Is Concerning

• Urgent symptoms: Fainting, severe dizziness, chest pain, shortness of breath, confusion, or inability to keep fluids down warrant urgent assessment. Cancer centers provide urgent care for treatment‑related complications and can evaluate acute hypotension. ^{[7] [8]}
  During infusions, report lightheadedness right away the team will check your blood pressure and manage it on the spot. ^[9]

• Medication red flags: If you recently started or changed an alpha‑blocker (like doxazosin) and feel dizzy or faint, contact your clinician to adjust therapy. ^{[1] [2] [3] [4]}
  If you are on therapies that usually raise blood pressure (like abiraterone or enzalutamide) but notice low readings, ask your team to review all medications, hydration, and possible interactions. [PM10] [PM11] ^{[5] [6]}

---

Practical Steps to Stay Safe

• Rise slowly and hydrate. Standing up gradually and drinking enough fluids can help prevent orthostatic drops in blood pressure. ^[10]
  If you feel lightheaded, sit or lie down immediately and elevate your legs. ^[10]

• Know your medicines. Keep an updated list, especially if taking alpha‑blockers or other blood pressure‑affecting drugs; inform every provider you see. ^{[1] [2] [3] [4]}
  Ask whether timing your alpha‑blocker at bedtime could reduce daytime dizziness. ^{[1] [2] [3] [4]}

• Monitor at home. Track blood pressure seated and standing; bring readings to appointments. Your clinicians may individualize targets to balance safety with symptoms like frailty or orthostatic dizziness. [PM8]

---

How Common Is Low vs. High Blood Pressure in Prostate Cancer Treatment?

• High blood pressure (hypertension) is common with certain anticancer drugs and often reversible when treatment is paused or completed. [PM10]
• Low blood pressure tends to be situational linked to alpha‑blockers, dehydration, acute infusion reactions, or intraoperative management rather than a long‑term effect of standard prostate cancer therapies. ^{[1] [2] [3] [4]} [PM7] [PM9]

---

Summary

Low blood pressure in the setting of prostate cancer care is usually due to medications like alpha‑blockers, dehydration, or procedures and is most concerning when it causes symptoms such as dizziness or fainting. Most prostate cancer drugs more commonly raise blood pressure, so persistent hypotension should prompt a review of all medications, hydration, and recent changes. [PM10] [PM11] ^{[1] [2] [3] [4]} Seek urgent care for severe symptoms, and let your team know promptly if you feel lightheaded during treatment. ^{[7] [8] [9]}

---

Quick Reference: Medications and Blood Pressure Effects

Item	Tends to raise BP	Tends to lower BP	Key notes
Abiraterone	Yes	No	Monitor BP; hypertension is recognized and managed during therapy. [PM11] [6]
Enzalutamide	Yes	No	Cases of high BP reported; check BP routinely. [5] [11]
Alpha‑blockers (e.g., doxazosin)	No	Yes	Can cause dizziness, lightheadedness, fainting; disclose history of low BP. [1] [2] [3] [4]
Surgery/anesthesia (prostatectomy)	Controlled intraoperative changes	Controlled hypotension used	BP deliberately lowered under monitoring to reduce blood loss. [PM7] [PM9]

---

What to Tell Your Care Team

• Your blood pressure readings (seated and standing), symptoms, and timing relative to medications. Clinicians often tailor blood pressure goals considering orthostatic symptoms and balance issues. [PM8]
• Any recent dose changes, new prescriptions, or dehydration (poor intake, vomiting, diarrhea). This helps identify reversible causes of hypotension. [PM10]

---

If you need help with urgent treatment‑related issues, your cancer center’s urgent care or emergency services are set up to manage complications like dizziness or fainting during therapy. ^{[7] [8]}