Our Friend (2019) and Advanced Ovarian Cancer

Told out of chronological order across roughly a decade. Matt Teague, a magazine journalist, and his wife Nicole, a singer and theatre performer, live in Fairhope, Alabama with their two young daughters. Nicole is diagnosed with advanced ovarian cancer. Their close friend Dane Faucheux, drifting through a job and a relationship in New Orleans, comes to stay for what he says will be a couple of weeks and ends up living with them for more than fourteen months, cooking, driving the girls to school, absorbing the household chaos and steadying Matt, who at first keeps travelling for work. Chemotherapy and surgery follow, then the news that the disease has spread and roughly six months remain. The final stretch at home brings pain, agitation, confusion and hallucination, and hospice support; Nicole dies at home with Matt and Dane present. Afterwards Matt writes the essay the film is based on, and Dane, hollowed out, gradually rebuilds his own life.

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

The caregiving is the truest thing in it. The film shows that most of the work is unglamorous logistics rather than bedside speeches, and that a friend who simply stays is worth more than anyone's advice. It is honest that a dying person's personality can change under pain, medication and disease, and that agitation, confusion and hallucination near the end frighten families who were not warned. It shows the cost to the carer, whose own relationship and career are quietly dismantled, and the confusion of children living inside a household organised around illness. Hospice at home, the children's presence, and the flatness of grief after the funeral are all handled without melodrama, and the timeline of diagnosis, treatment, spread and decline follows the real family's.

The film sanitises what Matt Teague wrote about. His Esquire piece described fistulas, open abdominal wounds, wasting and a body failing in ways that were degrading and hard to look at; the film keeps Nicole recognisable and largely camera-ready far longer than her actual illness allowed. Treatment is compressed into montage, so the specifics of ovarian cancer care, debulking surgery, platinum-based chemotherapy, recurrence and the decisions around stopping, are largely missing. There is also little about why the cancer was found so late, which for this disease is the single most important fact.

Ovarian cancer is often called silent, but it usually does cause symptoms; they are just vague and easily blamed on something else. The common ones are bloating or a swollen abdomen, pelvic or abdominal pain or pressure, feeling full quickly or difficulty eating, and needing to pass urine urgently or often. Fatigue, back pain, constipation, changes in periods and pain during sex also occur. What matters is that the symptoms are new, persistent, happening most days for a few weeks, and unlike your normal pattern; that is the point to see a doctor. There is no screening test for ovarian cancer for women at average risk. The USPSTF (2018) recommends against screening asymptomatic women who do not have a known high-risk hereditary syndrome (Grade D): large trials showed that CA-125 blood testing and transvaginal ultrasound did not reduce deaths from ovarian cancer, while producing many false positives that led to unnecessary surgery, some of it with serious complications. A cervical screening or Pap test does not check the ovaries. Women with a strong family history of ovarian or breast cancer, or a known BRCA1, BRCA2 or Lynch syndrome mutation, should be referred for genetic counselling, where different surveillance and risk-reducing options apply.

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 one thing you can do before anything is wrong at all. See screening and possible warning signs.

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Our Friend is worth watching as a film. It is not a guide to the disease it portrays. The gap between the two is what this page is for — and the thing worth carrying away is that a change which 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].