Paul L Nguyen

Paul L. Nguyen is an American radiation oncologist and researcher specializing in prostate cancer research and clinical care. Nguyen has worked with the Dana–Farber Cancer Institute, the Brigham and Women's Hospital, and Harvard Medical School, and his research has sought to assess the effectivity of hormone-targeted therapy in treating prostate cancer, the importance of social systems like marriage on cancer-related outcomes, and the personalization of therapy for prostate cancer patients based on genetic risk, among other questions.

Early life and education Nguyen received an AB from Harvard University in 1998; he had studied philosophy while on the pre-med track. After graduating, he deferred his acceptance to Harvard Medical School for two years to work at Boston Consulting Group.

Afterward, Nguyen earned an MD from Harvard Medical School; he also completed an MBA program at the MIT Sloan School of Management. He then completed his residency at the Harvard Radiation Oncology Program as a chief resident.

Career Nguyen is the director of radiation oncology at the Dana–Farber Cancer Institute's Lank Center for Genitourinary Oncology. He also serves as its vice-chair for clinical research, in addition to serving as a professor in the Department of Radiation Oncology at Harvard Medical School.

At Brigham and Women's Hospital, Nguyen is the Baldwin-Politi Distinguished Chair in Oncology and the Associate Director of the Harvard Radiation Oncology Program residency. In particular, he directs fellowships/residencies in Adult CNS Radiosurgery/Radiotherapy, Brachytherapy, and Supportive and Palliative Radiation Oncology.

Research

Androgen deprivation therapy Androgen deprivation therapy has been considered standard treatment for aggressive prostate cancer, but there have also been debates about ADT's side effects "including hot flashes, weight gain, diabetes and loss of sex drive—and, more recently, to cardiovascular risks"; a 2011 study also associated ADT with higher risk of blood clots.

In 2011, a study in the Journal of the American Medical Association led by Nguyen found that hormone-targeted therapy, specifically ADT, reduced the "overall risk of death" for individuals with aggressive prostate cancer.

Penile size study Following treatment for prostate cancer, some men have reported shrinking of their penises on internet forums like MedHelp. One man, 32 years old at the time, stated:I specifically asked my doctors before the surgery multiple times about possible complications and cosmetic outcomes and never once was possible penile shortening mentioned... Erectile length probably shouldn't matter if the surgery is otherwise successful, but I would've preferred at the very least a warning about the risk of shortening—even if temporary—so I could've at least psychologically prepared for the possibility or perhaps opted for another treatment.

The study, published in Urology, found that only 25 men out of 948 reported reduced penis size; stratified by treatment, the study observed that the reports came from those who received surgery or radiotherapy with androgen deprivation therapy. The study's conclusions noted an association between perception of reduced penile size with "greater interference with close emotional relationships and increased treatment regret" and recommended the discussion of perceived reduced penile size as a side effect of prostate cancer treatment.

FORMULA-509 trial Nguyen was the principal investigator of the FORMULA-509 trial, a randomized, multi-center, open-label trial in prostate cancer. The study found statistically significant benefits for certain groups of patients, stratified by prostate-specific antigen (PSA), but not others.

PREDICT-RT trial Nguyen was the principal investigator for the NRG-GU009 or PREDICT-RT trial at NRG Oncology. The trial utilized the Decipher score, a genomic assay used to stratify high-risk prostate cancer patients based on genetic risk. Nguyen's interest in genetic markers for prostate cancer had emerged from a dissatisfaction with the "one-size-fits-all" approach in prostate cancer treatment at the time: "When a man is diagnosed with high-risk prostate cancer, we don’t have a widely accepted way to sub-classify their cancer and truly personalize their therapy, but we think we will in the near future."

In 2021, Nguyen reported to the American Society for Radiation Oncology that Decipher scores were "independently associated with distant metastases (DM), prostate cancer-specific mortality (PCSM) and overall survival (OS)". The PREDICT-RT trial thus sought to investigate new ways of personalizing therapy and determine whether to intensify or de-intensify therapy depending on genetic risk determined by the Decipher score. Specifically, in the trial, individuals with lower genetic risk were given hormone therapy treatment schedules lasting 12 months rather than 24 while individuals with higher genetic risk were given the standard 24 months along with Apa.