Illlustration: Robin Cowcher

Illlustration: Robin Cowcher

The wider community has moved on from talking about Derryn Hinch's recent liver transplant, yet the community of cancer patients has taken some time to digest the news. So it was that as recently as this week patients asked, begged and challenged me to get them a new liver too.

A mother with pancreatic cancer, surrounded by her teary-eyed children, mildly suggested that I could ask the experts at least. The Serbian man in the next bed wasn't nearly as polite. His war-hardened self soured further by a diagnosis of advanced lung cancer, he had no qualms alleging that the difference between he and Derryn lay in fame and fortune. Another patient with colon cancer said in hushed tones: ''Can I pay you to get me a good liver?'' I patiently explained to all of them that it was not discrimination but their underlying disease that made a liver transplant impossible.

In answer to their glum expression, I added: ''And a transplant isn't as easy as it sounds. Transplant patients have a lifetime of complications and anxieties ahead of them.'' Alas, not a single patient seemed convinced; as one disappointed man put it succinctly: ''I guess you wouldn't say any different, doc.''

My patients' responses had me reflecting once again on the role that celebrities play in both raising health awareness and dashing the hopes of the ordinary patient. The experiences of Kylie Minogue gave breast cancer an even more prominent platform. There was a small increase in screening mammograms for a while as women came to appreciate that breast cancer can afflict even the glamorous.

But inevitably there were comparisons and with them came disappointments. Kylie's surgeon was booked out. Did I have some special sway with her, even if I maintained that there were many other equally expert breast surgeons? Did Kylie get a special drug not available to the rest?

By and large, cancer patients are extraordinarily gracious and not the sort to dig for a conspiracy theory, but every time a celebrity cancer hits the news, I can see how easily the occasion taps into their vulnerabilities.

When was the last time a gossip magazine featured on its front cover (or anywhere) a more realistic picture of a cancer-stricken patient - a sallow, thin, balding man, clutching a plastic bag just in case another wave of nausea catches him unawares? Or for that matter, a woman who feels unsexy every waking minute - who battles her weight, hates her wig, and rues her brittle nails?

Of course they wouldn't, you say. That wouldn't sell! And you would be right. You could also argue that putting a familiar face on the cover of a magazine boosts cancer awareness and provides inspiration. After all, who is not inspired by Jim Stynes?

But every time we fete a celebrity for possessing a special brand of courage, determination or spirit to fight cancer, we must remember that there is a particular section of society, namely cancer patients themselves, who are forced to question their own commitment to getting better. Just as the photos can be airbrushed, so can the real struggle of recovery.

When we heard in Hinch's immediate post-operative period about his adeptness at using his electronic devices, some of my patients felt surprisingly hollow. ''It's been a whole two days, doc, and I feel absolutely awful,'' a similar-aged man said apologetically. ''What's wrong with me?''

To be fair to both Hinch and his doctors, all have mentioned the rocky road ahead. Organ transplants are bedevilled by early and late complications that can be severe, even fatal. Although transplant recipients receive a new lease on life, they also inherit a new list of concerns - the true significance of which only becomes apparent with time. The problem is that these notes of caution do not make for good sound bites, but merely reintroduce us all to the drudgery of disease.

The average level of health literacy in the population is dismally poor. Few people, including cancer patients, realise that Derryn's cancer arose in the liver, in contrast to the vast majority of liver cancers that have travelled there from another organ, most commonly lung, breast or bowel. Even fewer would be able to list a few of the common complications of a liver transplant. And yet, there is now a myth - liver cancer equals transplant. Just ask Hinch. This kind of misconception may not mean much if you don't suffer from cancer, but if you do, it's yet another hope cruelly dashed when your doctor says otherwise.

Nevertheless, there are some lessons we can draw from the experience. Despite the frequent criticisms of the quality of Australian healthcare, our collective health is guarded by a mature, skilled and healthy system.

Does it mean every needy individual will receive a timely transplant? No. But it does mean that the majority of people will and do get high-quality basic healthcare and many other life-saving drugs and devices.

The media, with their tremendous reach, need to be cautious about oversimplifying a whole range of medical matters. Euphoric reports that brush over important details do not serve any good purpose, and cause potential harm. People are more likely to turn to a newsflash or sound bite than even a basic information sheet on cancer, so those who dispense the information must show particular caution and sensitivity.

Finally, in an era of unprecedented medical advancement, we need to improve our collective health literacy to navigate the information with which we are bombarded. Only then will we be able to ask meaningful questions about our own health and harness the benefits of medical progress.

It is through some of these measures that I hope we will greet the next liver transplant with the applause the feat deserves, without mistaking it for the panacea that it is not.

Ranjana Srivastava is a Melbourne oncologist and the author of Tell Me The Truth: Conversations with My Patients about Life and Death.

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