50/50 (2011) and Soft-Tissue Sarcoma of the Spine

Adam, 27, has persistent back pain. A scan finds a rare sarcoma along his spine. He is given a survival figure of roughly fifty per cent, starts chemotherapy, sees an inexperienced young therapist, and watches his relationship, his friendship and his relationship with his mother all reorganise around the diagnosis.

Spoilers throughout. Discussing the cancer storyline means discussing how this ends.

More than almost any film on this list. The googling of your own survival rate in the first hour. The friend who is useless and essential at once. Chemotherapy as tedium rather than montage — a room, a chair, other people, hours. The way everyone else's feelings become something the patient has to manage. It was written by Will Reiser from his own diagnosis, and it shows.

The delivery of the diagnosis is played for how badly the doctor does it, which is true to many experiences but not universal. And Adam's fifty per cent is stated with a cleanness real oncology rarely offers; survival estimates come as ranges built from groups of people, not as a coin-flip handed to an individual.

Adam's route in is the one worth noticing: back pain that did not go away. Back pain is overwhelmingly common and almost never cancer. What made his different was persistence without an obvious cause in a young person. NCI's guidance on soft-tissue sarcoma is that the usual first sign is a painless lump that grows, or pain when a tumour presses on nerves or muscle. Sarcomas are rare, and most lumps are not cancer — but a lump that is growing, is deeper than the fat layer, or is larger than a golf ball is worth having examined.

A film is not a diagnosis, and a dramatised illness is not a guide to your own. What a story like this is genuinely good for is lowering the barrier to a conversation you might otherwise put off.

If something in your body has changed and stayed changed for a few weeks, that is worth raising with a doctor — not because it is likely to be cancer, but because most of the time it will not be, and finding that out is the point. Where screening exists for a cancer, it is the only thing on the list you can do before anything is wrong at all. See screening and possible warning signs.

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50/50 is worth watching as a film. It is not a guide to soft-tissue sarcoma. The gap between the two is what this page is for — and the one thing worth carrying away is that a change that persists is worth a conversation, whatever a story led you to expect.

This page describes a work of film or television for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].