John Crawford Hardaway, M.D., surgical oncologist, is now seeing patients at Texas Oncology Surgical Specialists–The Woodlands, Kingwood, and Houston Willowbrook. Dr. Hardaway shares how he has seen immunotherapy change the course of cancer treatment and which famous historical figure he would most like to have dinner with.
Did you always know you wanted to specialize in surgical oncology?
A shadowing experience with a cardiothoracic surgeon during high school drew me to medicine. This surgeon performed heart and lung transplants, which is where I first learned of the immune mechanisms involved in organ tolerance. This fascination with the immune system led me to pursue an M.D. and Ph. D. at the University of Missouri, where I trained as a cellular immunologist in addition to earning my medical doctorate. It was not until my intern year as a surgical resident at the University of Washington in Seattle when I met a surgical oncologist who studies the tumor microenvironment in patients with pancreatic cancer, that I decided to become a surgical oncologist. I realized that a career in surgical oncology afforded the opportunity to operate on many different organ systems throughout the body, and my immunology background meshed well with the rapidly emerging field of cancer immunotherapy.
What is the biggest lesson you have learned from working with cancer patients?
Faith and fortitude are two of the greatest determinants that often go hand in hand in a patient's quality of life during their cancer journey. I try to add to that experience by encouraging my patients through every step. I engage their family, friends, and anyone willing or able to support them through the process. The delivery of cancer care is a team sport, and we need all players on the team to contribute, no matter how big or small.
In your opinion, what is one of the most important breakthroughs in cancer research to date and how have you seen it change the course of treatment?
Immunotherapy is now a verified and potent pillar of cancer care. One of my most memorable successes with immune checkpoint inhibitor therapy was regarding a patient with skin cancer on her upper arm that stretched over her biceps and triceps. In the past, we would have likely had to amputate her arm, but she responded so well to immunotherapy that I only had to excise a small residual lesion the size of a silver dollar, and she retained full function of her arm. I’m also excited about what lies ahead for immunotherapy. Over the past two decades, we have witnessed a massive expanse in biotechnology and bioinformatic techniques, which has ushered in a new era of ‘big data’ both in the lab and at the bedside. As we learn how to use artificial intelligence platforms to infer and develop more accurate biological models from these large datasets, we will see the next set of major breakthroughs in cancer immunotherapy.
If you could have dinner with one historical figure, who would it be and why?
This one was tough, but I ultimately decided to go with Leonardo da Vinci. I have always admired his study of the form and function of the human body. He was an artist as much as he was an engineer, which is what made him a true innovator of his time. It would be amazing to explain medicine as we know it today from a molecular perspective and see what kind of artistic renderings and depictions he would produce.
If you could only listen to one song for the rest of your life, what would it be?
‘Superstition’ by Stevie Wonder. It has that mix of funkiness and soul that doesn’t stick to a rudimentary rhythm. It’s almost like there are four rhythms in that song.
What was your favorite activity to do as a kid?
I played a lot of different sports growing up. I raced BMX bikes, played baseball, basketball, tennis, volleyball, and so on. The camaraderie I had with my teammates was what I really loved. I have fond memories of playing 3v3 basketball on hot summer days or riding my bike around town, exploring the suburban streets or the dirt jumping trails scattered throughout. It provided a sense of freedom and independence that is less common these days. The diversity of these interests equipped me with versatility and adaptability that serves me well in medical practice where I meet with people from a variety of interests and perspectives in life.
Do you prefer coffee or tea to start your morning?
I’m sorry to say, I never have been much of a tea guy—hot or iced, sweetened or unsweetened. I know, it’s not very Texan or Southern of me! I think it stems from one of my college jobs as a barista, making lattes and cappuccinos. I’m drawn to the science and precision of a perfectly pulled espresso shot and the frivolity of making latte art.