You measure your success in five-year increments. Your doctors let you know if your blood counts are high or low. You bite your lip, not sure if you want to know if you're stage 1, 2, 3 or 4. Cancer -- it's a numbers game. So when I went to Sloan-Kettering last week to discuss a drug that's effective in 30 percent of patients for my melanoma that has a roughly 10-20 percent survival rate , it didn't come as much of a surprise when my doctor said, noting proudly that I've lasted almost 14 months already, "The odds have been against you from the start." 
 
 It's clear right from the title that the poignant, funny and profane "50/50" understands the woozy terror of a life or death crisis. Why then is it being peddled as "the comedy from the guys who brought you 'Superbad'?" What's so funny about cancer? Believe it or not, quite a lot. 
 
 Joseph Gordon-Levitt is Adam, a tightly wound NPR drone who rhapsodies about Swiffers and refuses to jaywalk even when there isn't a car in sight. His best friend Kyle, played by Seth Rogen, is a guy whose interests include getting high and talking about blow jobs in the latte line. So what happens to these two kooky fellas when 27-year-old Adam discovers he has a rare form of spinal cancer and just a 50 percent chance at survival? 
 
 What ensues is "Beaches" meets "Pineapple Express." Which, I've got to tell you, is pretty much what living with cancer is like. The movie has good reason to resonate so truthfully -- it was written by television producer Will Reiser, who himself endured cancer in his mid-20s. Rogen was there for it all. No wonder the movie has such a brutal, honest sting. 
 
 Thrust into a world of procedures, treatments, WebMDing, and doctors who say everything much too fast -- all while his friends are blithely bar-hopping -- Adam must quickly adjust to his strange and frightening new status. Co-workers give unsolicited advice and tearful hugs, his mother (a steely Anjelica Huston) flies into drama queen mode, and his girlfriend suddenly keeps him at arm's length. Kyle, meanwhile, angles the situation into opportunities to smoke dope and get laid. 
 
 Gordon-Levitt, combining his "(500) Days of Summer" angst with "Inception" efficiency, does a terrific job of capturing the emotional gamut that is illness. Adam, a control freak in an out-of-control situation, pings between panic and wry amusement at the absurdity of his situation, the humbling awfulness of it all. But the movie's biggest surprise is the usually one-note Rogen, who manages to be both glib and genuinely vulnerable. 
 
 Where "50/50"breaks ground, however, is its understanding that neither illness nor friendship is some pink-ribboned chick thing. This is a film self-aware enough to crack a "Terms of Endearment" joke, to compare its chemo-bald leading man to both Lord Voldemort and Michael Stipe, and to understand that surgical wound care is an awful lot like one of the "Saw" flicks. In other words, dudes, you don't even have to have cancer to appreciate its vulgar, vulgar heart. 
 
 Unsurprisingly, Rogen and company, like true students of the Judd Apatow school of filmmaking, never quite get a grip on their female characters. Anna Kendrick is Adam's much too young and inexperienced therapist -- a girl who serves more as crush object than a real character. And Bryce Dallas Howard, rapidly on her way to becoming Hollywood's go-to ice bitch, plays Adam's artist girlfriend Rachel as a hateful little bundle of narcissism. 
 
 Rachel does provide one of the film's most insightful moments. As Adam heads into the hospital for his first chemo session, she opts to sit in the car, explaining that she can't go into "that world." Cancer is indeed a different world. And what "50/50" shows, with great and bittersweet clarity, is that not everyone will be able or willing to go into that world with you. 
 
 Rachel's refusal to mix "the negative with the positive" is at once a stone cold dis and a perfectly logical reaction. Who, after all, would choose to spend time in a cancer ward? Who would consider sickness anything but a negative? But what "50/50" gets -- that poor Rachel doesn't -- is that moments of the greatest joy and connection and unadulterated freedom coexist with the horror and fear and pain. That love and silliness can get you through just about everything. As a woman whose friends have showered her with cakes festooned in expletives and T-shirts bearing the image of Monty Python's indomitable Black Knight, I can testify that the real Big C -- just like "50/50" -- is both a three-hanky weeper and a total farce. And that although every day of life is a gamble, every day is also, amazingly, a gift. ||||| Loosely inspired by the real-life cancer battle of screenwriter Will Reiser, "50/50" is 50 percent affecting medical drama and 50 percent first-rate character study. It's also a comedy that sometimes makes you feel uneasy about laughing. 
 
 Joseph Gordon-Levitt plays Adam, a 27-year-old Seattle radio reporter stunned to learn that his back pain doesn't stem from jogging but malignant spinal cancer. His odds of survival are even money, and the film details the turmoil that this half-death-sentence unleashes in Adam's relationships. Adam, a mild, stable, tidy sort, has just slammed into the Mount Everest of messes. 
 
 Best friend Kyle (Seth Rogen) reacts to Adam's news with candid alarm, then declares that they'll beat the big C together, as if you can tag-team osteosarcoma. Since Kyle is a blowhard with the emotional grace of a bull in a china shop, he's not the ideal companion for what may be Adam's final days. His idea of being supportive is urging Adam to shave his head and look more cancer-y so they can score some sympathy sex at the pickup bar. "He still has his sense of humor!" Kyle barks. "It's inspirational!" But Adam has to fight this battle with the recruits he's got, and he's got Kyle. 
 
 He also has an overprotective mother (Anjelica Huston), who finds ways to make her son's calamity all about herself, announcing that she's moving in with Adam, a smothering move that is as concerned as it is insensitive. Add to the mix Adam's self-absorbed girlfriend (Bryce Dallas Howard, perjury in every wide-eyed smile) and his novice therapist (Anna Kendrick, painfully sincere and overwhelmed), and you have a formula for emotional havoc. 
 
 Director Jonathan Levine has the ideal approach to the material, which is to stand aside, frame each scene honestly and let the actors drive the story. Gordon-Levitt is impressive as a regular Joe sideswiped by all the world's cruelty and injustice. He gives us the sense of a man groping for something to keep him afloat while trying not to panic. He's abject, stoic, antic, wistful but always proud even as his capacities diminish, never stooping to make poor-me claims on our sympathy. Rogen's performance is not of the sort to entirely please his admirers, and hooray for that. His man-child excesses are exasperating until they're revealed as the only morale-boosting strategy that this boisterous lummox can imagine. 
 
 The script follows the zigzag of messy life, not the three-act pattern of screenplay manuals. Drawing from his own experience, Reiser avoids artificial humor, synthetic situations and tidy epiphanies. He stubbornly, consistently plays every moment for matter-of-fact realism. Nothing feels preordained, least of all the ever-shifting mood. 
 
 The reason "50/50" works is it's not trying to force us into any particular emotion. It fits in the emerging category of sad-man comedies such as "Up in the Air" and "Crazy, Stupid Love," telling its downbeat tale with tenderness, sincerity and warmth. "50/50" isn't a cancer buddy comedy or a male weepie but a message movie. The message is that you can tackle pretty much any subject matter and tell a story any way you want to onscreen as long as it's absorbing. ||||| As its title unintentionally indicates, "50/50" walks a very tricky line. As a comedy about a young man with cancer , it needs to be serious enough to be real as well as light enough to be funny. Though it falls off the wagon at times, it maintains its balance remarkably well.Several factors contribute to that success, including artful direction by Jonathan Levine and an expertly assembled cast, top lined by Joseph Gordon-Levitt Anna Kendrick and Bryce Dallas Howard (rapidly becoming today's preeminent Queen of Mean).But the key element in "50/50" is the screenplay by Will Reiser, a young writer who, as has been widely reported, was inspired by his own experience as a twentysomething diagnosed with a rare type of cancer.Reiser discourages viewing the result as autobiographical (unlike character Adam Lerner, the writer did not undergo chemotherapy before his complex surgery), but the texture of his experience ensures that the film will have as much reality as the genre can handle.Though he was a last-minute replacement for a departing James McAvoy , Gordon-Levitt could not be a better choice to play protagonist Adam. Known for roles in films as diverse as "Inception" and "(500) Days of Summer," the actor can play sensitive without drifting into needy, has an easy way with humor and is expert at getting audiences to identify with his predicament.When the 27-year-old Adam, a nervous type who works for public radio in Seattle, finds out that the mysterious pains in his back come from a malignant tumor growing by his spinal column, he is understandably disbelieving. When he's told his chances of surviving are 50-50, he is aghast, but best friend and co-worker Kyle sees things differently. "If you were a casino game," he insists, "you'd have the best odds."Kyle is played by Rogen (a real-life friend of screenwriter Reiser) and, in typical profane Rogen fashion, his character is always going to be brasher, louder and more out of control than polite society would like. Who else, for instance, would think of using his friend's cancer as a way to pick up women? Yet there is finally a guilelessness about Kyle, a kind of crackpot innocence, that makes us happy he is around.The actresses playing the key women in Adam's life (casting was done by Francine Maisler, who did "Moneyball" ) also hit the right notes.Met first is Rachael, an ambitious artist who is Adam's girlfriend. Beautifully portrayed by Howard (who similarly devoured the part of the evil Hilly Holbrook in "The Help" ), Rachael does not seem the "through sickness and health" type, but she insists she is, and even presents Adam with a canine companion (a greyhound named Skeletor who looks like death warmed over) as a sign that she has his best interests at heart.Also on Adam's team, though he doesn't always think so, is Katherine (Kendrick), his hospital-assigned supportive care therapist. So newly minted at the job that Adam is but her third client, Katherine wants to do the right thing, but her inexperience is not her friend. Kendrick, Oscar-nominated for "Up in the Air," brings a combination of precise intelligence and sweet-natured screwball wackiness to a part that benefits from all of her abilities.Because it is a comedy, "50/50" isn't intent on showing all the bad sides of a serious illness: Hospital personnel are invariably pleasant here and no one has to wait too long in an uncomfortable waiting room.But, unusual for a comedy, "50/50" doesn't allow the humor to stray too far from the pain. We see the damage that fear, rage and chemotherapy do to Adam's life, and we are not allowed to forget that cancer is not just the disease-of-the-week but something that actually kills people.Not everything in "50/50" is as successful as its best moments. Anjelica Huston overdoes it as Adam's mother, and making his father an Alzheimer's sufferer seems excessive as well. But though its mixing of tones and intentions may sound cloying on paper, having all members of the creative team on the same page about what they were after and how they were going to get it has helped enormously."50/50" may be an unlikely hybrid, but it grows on you. ||||| In Hollywood where actors mostly come in two flavors, rocky-road action heros who say little and sourball fast talkers who profane much, Joseph Gordon-Levitt is quietly carving a caramel chameleon niche of his own. Whether as the audacious dream-invader in Inception, the rueful hustler with a black hole where his heart should be in Mysterious Skin, or a spurned swain in [500] Days of Summer, JG-L uses his burnt-sugar eyes to invite and resist viewer sympathy. In 50/50, Levitt waves you off and pulls you in as Adam, a mild-mannered 27-year-old diagnosed with a rare form of cancer. The title refers to his chances of survival. In Las Vegas, those are good odds, muses Kyle (Seth Rogen), Adam's wild-mannered buddy. At the hospital, not so much. 
 
 Loosely based on the experiences of screenwriter Will Reiser and produced by Rogen (his writing buddy on Da Ali G Show), 50/50 mines absurdist humor from the veins of mortality. 
 
 Levitt, the definition of nuance, is touching, funny, and fierce - an unusual combination of moods, but deeply affecting. 
 
 In the film directed by Jonathan Levine (The Wackness), Adam is a draw-inside-the-lines kind of guy - the kind who, when out jogging at 5 a.m., stops for traffic lights although there's no traffic at that hour. 
 
 Adam is so busy comforting friends and family that he can't take the time to process it himself, a source of the film's most comically moving moments. 
 
 He props up his mother (Angelica Huston, heartbreakingly funny), he props up Kyle, he tries to put the best possible face on his diagnosis to his girlfriend, Rachel (Bryce Dallas Howard). When the hospital assigns Adam a psychologist, Katherine (Anna Kendrick), turns out that she is a trainee and he only her third patient. He props her up, too. That is, until she finds her professional footing. In a move that would be considered unprofessional, she speaks to him as a friend rather than a therapist. And she gets through. 
 
 Admittedly, the film has its sitcom moments, as when Kyle coaches Adam to use his diagnosis as a way of picking up girls. But Levitt drills deeper than sitcom shale, and the result is beautifully modulated, desperately funny terror. His performance creates the impression of one gracefully dancing through a minefield. 
 
 In the film's third act, Adam faces a risky experimental procedure as he navigates his relationship (is it professional? is it personal?) with Katherine. 
 
 Playing a novice professional who thinks she has the answers even though she's reading from a cheat sheet, Kendrick is doing a variation on her character from Up in the Air. Yet her performance and timing are utterly original. 
 
 In more than one way is the film 50/50: It's half hilarious, half serious; all poignant. 
 
 Contact movie critic Carrie Rickey at 215-854-5402 or crickey@phillynews.com. Read her blog, Flickgrrl, at http://www.philly.com/ flickgrrl.
– With a current 92% rating at Rotten Tomatoes, 50/50 gets praise for its blend of comedy and drama about a young man diagnosed with cancer. In Salon, Mary Elizabeth Williams calls the movie “poignant, funny and profane”: It “understands the woozy terror of a life or death crisis,” she notes—though “unsurprisingly,” Seth Rogen et al., “like true students of the Judd Apatow school of filmmaking, never quite get a grip on their female characters.” The movie “needs to be serious enough to be real as well as light enough to be funny,” observes Kenneth Turan in the Los Angeles Times. “Though it falls off the wagon at times, it maintains its balance remarkably well.” Colin Covert, writing in the Minneapolis Star Tribune, calls the film “50% affecting medical drama and 50% first-rate character study.” And in the Philadelphia Inquirer, Carrie Rickey says lead actor Joseph Gordon-Levitt is “the definition of nuance, is touching, funny, and fierce—an unusual combination of moods, but deeply affecting.”