50/50 is based upon the experience of screenwriter Will Reiser, a writer for HBO’s Da Ali G Show who contracted cancer before his 30^th birthday. Reiser’s real-life travails with his buddy Seth Rogen (who serves as executive producer) through the good times and bad. I guess when you get cancer it helps to have an established movie star as your good friend. It also helps when you write a terrific script, which Reiser has accomplished. Originally titled I’m With Cancer, I guess the studio felt that a movie with “cancer” in the title was a hard sell to mass audiences (On a related note, Showtime’s comedy-drama The Big C, about Laura Linney finding the humor through cancer treatment, was previously titled The C Word. I don’t know about you, but when I heard “the c word” the first thing that comes to mind is not “cancer.”). Even with a more oblique title, 50/50 manages to walk between comedy and drama with flair. It’s probably the funniest movie you’ll ever see about cancer. Definitely funnier than My Sister’s Keeper.

Adam (Joseph Gordon-Levitt) is a relatively healthy 27-year-old. He likes his job writing for a Seattle National Public Radio station. He likes his girlfriend, Rachel (Bryce Dallas Howard), an aspiring painter. He likes his best friend, Kyle (Rogen), a dude prone to speaking whatever is on his mind. Then one doctor’s visit changes everything. Adam has a very serious form of spinal cancer. He begins chemotherapy to try and stop the tumor’s growth. Rachel drives him to his hospital treatments, helps him during his long nights of nausea, but ultimately it proves too much to bear. She leaves him. Luckily, Adam has a young therapist, Katherine (Anna Kendrick), helping him put his life in order. Adam’s chances of surviving this rare cancer are exactly as the title proclaims, 50/50. As he comes to grips with the measures needed to survive, Adam finds himself growing closer to his therapist in a completely unprofessional degree.

50/50 may be the least sentimental movie I can recall about the realities of living with cancer, and that is its greatest attribute. That doesn’t mean that the movie doesn’t cover serious issues in a flippant manner. Instead of hitting cheap sentiment and milking cancer for easy tears, the movie, thanks to Reiser’s sharp script, forgoes false feelings and finds something more rare and true. There’s no real playbook for something as unexpected as a person in their 20s being diagnosed with terminal cancer. It seems like a cruel irony to be stricken with an illness so young. Adam doesn’t drink, doesn’t smoke, and doesn’t even drive due to the danger. He’s pretty mild-mannered and a bit of a pushover. Adam tries to not let cancer get to him, to shrug off the heavy implications, and to just make it seem like any other personal setback. If he doesn’t treat it like a big deal, maybe it won’t be and his friends and family can follow his lead. This kind of self-manufactured blasé attitude, even in the face of cancer, seems like an apt approach for a younger relaxed generation. Naturally, this denial-heavy approach doesn’t exactly work. It’s too easy to confuse numbness with acceptance. Fortunately, Reiser does not let his story slip into easy maudlin theatrics. We don’t need anybody reminding us, or Adam, how serious his situation is. On the other hand, we also don’t need anybody moralizing about any self-help slogans. Not everyone sees adversity as a blessing into Discovering Who You Truly Are. Reiser refrains from his characters making anything approximating Big Life Statements. Cancer does not lead to automatic personal epiphanies. If it did, we’d have a lot more people inhaling carcinogens and volunteering to work in the Chernobyl ruins.

50/50 doesn’t ignore the sometimes odd and dark humor that arises from life’s predicaments. That means this is the only cancer movie where the guys try and use the disease as a way to convince girls to sleep with them. At no point do I remember this occurring with Terms of Endearment or Beaches. And this opportunistic babe hunting doesn’t make the boys come across as sleazy. Adam can’t even enjoy the one-night-stand as his back pain robs him of the pleasure of his nubile well-wisher. The tone is very controlled. The raunchy comedy is not a distraction; at no point does any situation feel like a comedic setup. The comedy comes from the characters being genuine to who they even through the trying circumstances. If your friends are funny, chances are they’ll still be funny talking about cancer. The humor doesn’t make light of things nor does it just play everything for laughs. Humor is how we humanize, how we make the insurmountable digestible.

50/50 also treats its characters with a bittersweet sense of reality; these people are flawed and relatable. They are not instantly made into self-actualized saints thanks to cancer. Adam’s girlfriend actually breaks down because she cannot handle the extra responsibilities and emotional wear and tear. Their relationship fizzles. This seems far more realistic considering many people will feel like they did not sign-up for sleepless nights, 24-hour care, and watching their loved one waste away. It’s a strong individual that can endure that kind of collateral pain, but the movies make it seem like every romantic partner is unnaturally selfless. They become ideal partners, but really most of us would just bail. Reiser easily could have easily written his ex-girlfriend as an insensitive shrew. While she does cheat on the guy, thus making her easy to dispel, Howard makes her vulnerability relatable. She even comes back trying to make amends, forcing kisses upon him to weaken Adam’s resolve. Kyle relishes the opportunity to finally be able to tell off Rachael, a girl he admits to disliking from the start. I don’t get the instant hate, but maybe it’s my complete adoration for Howard even when she’s playing a bad girl that blinds me to her offenses. To dismiss her as a “bitch” seems unfair. How would you react if your boyfriend/girlfriend were suddenly diagnosed with cancer? Could you last?

I found all of the characters to be empathetic and relatable (though a lead who waxes about the glory days of radio and works for NPR seems a bit hipsterish), especially in their personal struggles surrounding Adam’s illness. Adam’s mother, Diane (Anjelica Huston), can be overbearing and would have easily been kept as a caricature in other movies. In 50/50, the film examines her own struggle – a husband with Alzheimer’s who can’t talk to her and a son with cancer who chooses not to talk to her. The isolation she feels, the loneliness, always putting other people’s needs ahead of her own, this is culmination of the caregiver, a role as I’ve stated that too often gets canonized. In 50/50, the reality of living with illness is dealt with in a meaningful manner. The people surrounding you are also affected by your illness. You cannot shut them out to spare them from pain. Adam realizes this too as the film progresses to its moving conclusion.

The heart of 50/50 concerns two sets of relationships. The one that will catch the most attention is Adam’s budding romantic relationship with his therapist. Their romance feels like it emerges naturally, albeit in a slightly hurried up pace for our small timetable. It’s a romance built upon the chemistry of the two actors, the strength of their individual performances, and the fact that Reiser forgoes anything obviously romantic. He cleans out her car. She gives him a ride home. It’s little things that seem like they matter on a personal level, not the outsized theatrics of romantic gestures. The movements are small but they add up, and we can feel it too. So when Adam, at his lowest point, calls her and says, filter down and radiating in emotion, “I bet you’d be a good girlfriend,” it’s a moment that feels earned. I also greatly appreciated Katherine’s own insecurity about being a therapist. Too often movies depict therapists as omniscient beings that have a fortune cookie answer for all of life’s mysteries. Kendrick hides behind evaporating smiles as her character’s defense mechanism. In 50/50, we get to see a character that is honest about her insecurities about a job that advises others. It’s refreshing. The other main relationship is between Adam and his best friend, Kyle. His best buddy is his spark, the guy who gets him out, who shakes him from moping around. He cares but goes through unorthodox methods to show that care, including trash talking and ball busting. He remains likable to his shaggy core because he has Adam’s best interests in mind, even if that means scoring with girls.

Director Jonathon Levine (The Wackness) gives the movie an improbably beautiful look. This is one cancer comedy that is simply pleasing to watch for the cinematography alone. He doesn’t overpower the narrative with self-aware visual touches, though there is one that stands out. When Adam receives the news from his doctor, the audio becomes distorted after the shocking word “cancer” is uttered. The picture becomes blurred. The world seems to have been swept away. I imagine this sonic body blow is pretty much how Reiser recalls receiving the news, and if not it still feels authentic. The score by Michael Giacchino (Up, Super 8) is subtle and doesn’t intrude too often, ably assisting the drama instead of smothering it.

50/50 is an unsentimental film that manages to be moving and genuinely entertaining on its own terms. It can be rude but that doesn’t mean it lacks sincerity. The characters and their dilemmas feel all too relatable, even the ones we hope don’t become us. The 50/50 production has followed a subdued edict, forgoing sappy melodrama and easy pathos. These emotions are earned the old fashioned way, through characters we care about and drama that feels truthful. The mixture of the course and sweet gives the film a decidedly Judd Apatow (Knocked Up) flavor even though his name is nowhere to be seen. Gordon-Levitt, who at this point can do no wrong in my eyes, gives one of the best performances of his already accomplished career. The comedy, lead by Rogen’s obnoxious best friend, keeps the movie from being bogged down in melodrama. It’s the only way to stay sane, and 50/50 recognizes this and delivers a film that earns its tears and laughs.

Nate’s Grade: A-