Seth Rogen (“Knocked Up”), Joseph Gordon-Levitt (“Inception,” “500 Days of Summer”), Anna Kendrick (“Up in the Air”) and Blythe Dallas-Howard (“The Village,” “The Help”) set out to make a dramedy (a combination of drama and comedy) about cancer in “50/50.”  The balancing act between humor and pathos is a delicate balancing act, but the film, written by writer Will Reiser and directed by Jonathan Levine works in telling the true story of a young man (Adam) who is unexpectedly diagnosed with cancer at the age of 27.  Reiser, who has a bit part in the film as “Greg,” was diagnosed with cancer in real life at age 25.

Seth Rogen, a Canadian native, enjoyed the standing ovation the film received at its Toronto Film Festival World Premiere. There is much to enjoy and appreciate in the bittersweet story of a life hanging in the balance and a good friend who stands by his buddy. The performances from all are spot-on and the cinematography and music are similarly skillful.

Rogen explained the film’s origins this way:  “We worked with Will (Reiser) on Da Ali G Show, and it was shortly afterwards that we learned he was sick.  As shocking, sad, confusing and generally screwed up as that was, we couldn’t ignore that, because we were so ill-equipped to deal with the situation, funny things kept happening.” (Facebook page for “50/50”). Or, as Director Levine told the Los Angeles “Times,” “Little Will got sick.  Now he’s fine. And we made a movie about it.  That’s crazy.”

It was crazy, in fact, that Jonathan Levine ended up directing the film at all. Levine had originally passed on the project (although he sent a complimentary note regarding the script) and a different director was set to helm, but dropped out.  It was only in the interim, when two of Levine’s family members were diagnosed with cancer, that he stepped in to direct.  As Levine said, “That (his relatives’ cancer diagnoses) made the script resonate that much more for me.  I went through those experiences where things are just so ridiculous and so intense that you have to laugh and I went through those experiences where things are so ridiculous sometimes that you have to cry.”

However, it’s a tough sell to get people into a theater to see a movie with the working title “I’m with Cancer.” Director Jonathan Levine realized that when the movie, ultimately titled “50/50,” was filming. [The second title “Live With It” didn’t take, either.]

It’s just as tough when your lead drops out a week before shooting is supposed to start. Originally, the part played by Joseph Gordon-Levitt was to have been played by James McAvoy (“Atonement”), but his wife went into labor and McAvoy went home. Joseph Gordon-Levitt had only 7 to 10 days to prepare for the part of Adam Lerner.

With the insertion of comic material in such serious subject matter, Director Levine says, “You never want to be too manipulative.  You never want to stretch for a joke.  You just want it to sort of unfold, the way life unfolds.” While the comedy works, some may criticize the serious parts of the film, saying Adam, the film’s central character, remains much too calm for much too long when in such dire straits. In only one memorable scene (while driving Rogen’s car) does Adam really lose it, emotionally. Adam is portrayed as an obsessive-compulsive neat freak who chews his fingernails and believes in the adage, “a place for everything and everything in its place.” Calm is an understatement for his demeanor after his diagnosis, considering that the rare hereditary form of spinal cancer he incurs has only a 50/50 survival rate before it metastasizes and a 10% survival rate after it spreads.

In the film, Seth Rogen’s character Kyle, after hearing the news of his friend’s illness, tries to cheer Adam up by citing other cancer patients who have beaten the odds. “F***** Lance Armstrong. He keeps getting it… Patrick Swayze.” Adam interrupts Kyle to mildly remind him that Patrick Swayze died. This seems to come as a news flash to Kyle (Rogen).

Seth Rogen’s reactions are priceless at all points. Although he will soon be too mature to play the part of a walking hormone constantly trying to get laid using any excuse possible, the Rogen vamping on this theme has been wildly successful in several previous films (“Knocked Up,” “The 40-Year-Old Virgin,” “Zack and Miri Make a Porno”). In this film, Rogen is “funny, sad and honest” (the announced goal of the film) at all points, whether he is helping shave Adam’s head, verbally nailing Adam’s cheating girlfriend, or helping his good friend change the bandages on his spinal incision.  Rogen reminded Gordon-Levitt of that scene, saying, “That was exactly how I reacted (to the large incision down Adam’s back—which he describes in the film as “Saw material”). I almost threw up on you.” For fans of “Falling Skies” with Noah Wylie this past summer television season, Adam ends up looking like he has had one of the infamous creatures removed from his backbone in much the same way as the hapless victims of the aliens of that TV show.

Perhaps the most amazing behind-the-scenes story about the film involves the head-shaving scene, which is featured on posters and trailers. As Director Levine described that day, “Will wrote the scene and then, within that, the specifics of the dialogue were totally improvised and the rest was improvised. It was the last thing we shot on the first day.  As I said, Joe (Gordon-Levitt) pretty much had 10 days, we barely knew the guy, and he had to shave his f****** head at the end of the first day.  And it was his first scene with Seth, as well.”

Other actors who excel in their parts are the Oscar-nominated Anna Kendrick (for “Up in the Air”) as Katie McRay, a compassionate 24-year-old therapist-in-training, who has only had 2 previous patients; Blythe Dallas-Howard as Rachael, Adam’s cheating girlfriend; and two elderly patients with cancer, played by Philip Baker Hall and Matt Frewer  (“Max Headroom”). When Frewer’s character of Mitch dies unexpectedly, the reality of Adam’s 50/50 odds sink in more seriously and the reality of life and death comes home to one and all.

(Dr.) Katie McRay (Anna Kendrick) is all about earnest attempts at touchy-feely closeness (“It’s like being slapped by a sea otter,” Adam says of her robot-like grabbing of his wrist in her office.  He calls it “creepy.”) Katie is all sympathetic smiles and clichéd book learned wisdom. You get the feeling that Katie has read all the books but is still feeling her way along in implementing these techniques in the real world. Another fine supporting performance from Kendrick. Upon learning that Adam considers his mother Diane (Anjelica Huston) to be “an irrational loon,” Katie tells Adam, “You can’t change who your parents are.  All you can change is how you react to it.” (Psych 101).  Kendrick continues her spacey, Diane Keaton-esque comic vamping. You only have to go back to “Up in the Air” where Kendrick shone, to realize that she will play many sensitive/comedic parts in future films.  George Clooney commented (at the time of “Up in the Air”) that Kendrick blew all the other actors (including himself) off the screen with her spot-on performance.

Bryce Dallas-Howard is equally good as Rachael, Adam’s girlfriend. She plays the villain of the piece. This is apropos, since Dallas-Howard is fresh off playing villainess “Hilly” in “The Help.”  Actor-director Ron Howard’s little girl is caught by Seth Rogen’s character making out with an artist at a gallery opening (an artist who, says Rogen, “looks like Jesus”). Adam is back home, zonked out from his illness and waiting for his girlfriend to get home. There is another instance when Rachael shows up very late to pick Adam up after his chemotherapy. She also refuses to enter the hospital to be with him during his chemo treatment. In other words, we see her exit from his life coming from several miles away and “good riddance to bad rubbish” is Kyle’s reaction.

Good friend Kyle (Rogen), playing amateur detective, takes a picture of the cheating couple with his cell phone. Rogen then confronts Rachael at Adam’s house immediately after the gallery showing, saying to Rachael, “You are reprehensible. You’re disgusting…I’ve hated you for months.” The two friends will later creatively unleash their hostility on an oil painting Rachael made for Adam.

The music in the film is outstanding, ranging from the Bee Gees to Pearl Jam, with Michael Giacchino scoring the film, Jim Block and Gabe Helfers music supervisors and Music Editor Stephen M. Davis. Still, Director Levinson, who used hip-hop in his 2007 Sundance film “The Wackness” had much input and was delighted to obtain an Oscar-winning composer (for “Up” in 2010) for this film saying, “So, yes, him (Giacchino) scoring was a major coup for us.” (Giacchino was also nominated for Best Original Score in 2008 for “Ratatouille”).

Up next for Director-on-the-way-up Jonathan Levine is a zombie movie with John Malkovich entitled “Warm Bodies.” Joseph Gordon-Levitt is filming “The Dark Knight Rises” in Pittsburgh. And audiences nationwide will get the opportunity on September 20th to enjoy “50/50’s” message of life’s fragility and the enduring and sustaining nature of true friendship.