It takes a lot of particles to form a wave. Julia Sweeney, the former "Saturday Night Live" cast member, speaking self-deprecatingly of her pioneering 1996 one-woman Broadway show about having cancer at the same time as her brother, said, "When I was doing 'God Said Ha,' people would say, 'You're finally making cancer funny. People haven't done that before.'
"But I didn't really see it that way. I mean, I found 'Love Story' pretty funny."
The existence of (not to mention the critical and commercial success of) the frank new cancer comedy film "50/50" prompts the question, "How did we get here?"
You can draw a line, however tenuous, that starts with Edith Bunker finding a lump on her breast and ends at Debra Winger languishing melodramatically in "Terms of Endearment." Or one that zigzags from Murphy Brown to Samantha in "Sex and the City" to Cathy Jamison (Laura Linney) in "The Big C." Or even one that starts with the mother of a cancerous baby praying to a god she calls "the Manager of Marshall Field's" in Lorrie Moore's gorgeous 1997 New Yorker story "People Like That Are the Only People Here" and ends with David Rakoff riffing on the word "schwanomma" in his recent book "Half Empty."
But by what scarily graphic and blunt route do we end at Seth Rogen and Joseph Gordon-Levitt in "50/50" manipulating a surgery scar so that it "talks" like Kuato, the "Total Recall" humanoid?
Securely located in the Judd Apatow bromance genre, the funny and affecting "50/50" puts a young radio producer, Adam (Mr. Gordon-Levitt) and his foul-mouthed chauvinistic friend, Kyle (Mr. Rogen), through a narrative arc of trauma and heartbreak and hostility after Adam is diagnosed with a rare form of spinal cancer.
We see the two men use Adam's cancer to pick up women; we see Adam's mother drop the "C card" in an effort to get someone to lower the air-conditioning; we see Kyle tell Adam that, were he his girlfriend, he'd be pleasuring him "every 30 minutes and baking you cookies." And, oh, there's a Patrick Swayze joke, too.
Will Reiser, who wrote "50/50," was told that he had a rare form of spinal cancer six years ago while working on "Da Ali G Show," and lived through the experience with his real-life best friend, Mr. Rogen. "I was 25 at the time," Mr. Reiser said. "I didn't know how to talk about it. I didn't have the emotional tools."
So, in a world in which Elisabeth Kübler-Ross's five stages of grief were an increasingly hoary comic meme, in a world in which people were publishing books with titles like "I'd Rather Do Chemo Than Clean Out the Garage" and "Not Now ... I'm Having a No Hair Day," Mr. Reiser and Mr. Rogen adopted a coping mechanism not dissonant with the times: they joked about the funny cancer movie that they might one day make.
Ask any purveyors of cancer comedy for the names of who they think paved the way for them, and you'll get different answers. Jenny Bicks, a breast-cancer survivor who wrote Samantha's storyline on "Sex and the City" and who now is on the crew of "The Big C," said, "Julia Sweeney made it O.K. to say, 'This happened to me.' "
Fran Drescher, whose 2002 memoir "Cancer Schmancer" included a chapter about losing her 19-year-old Pomeranian and her uterus in the same year, said: "Richard Pryor and Gilda Radner. They found the funny bone and allowed people not to be so scared."
The comedian and podcast host Marc Maron (who, though never diagnosed with the disease, tells a joke about a cancer scare he had after eating licorice one day) points to the late comedian Robert Schimmel, who used to tell an unprintable joke involving the Make-A-Wish Foundation and Dolly Parton.
Mr. Reiser cited Larry David. "Without Larry David, there probably wouldn't be a movie like '50/50.' " The seventh season of Mr. David's show "Curb Your Enthusiasm" saw the curmudgeon get into a literal drag race with his girlfriend Loretta's doctor so that Mr. David could break up with Loretta before she was given a diagnosis of cancer.
"That's Larry's character's way of dealing with life," said Vivica A. Fox, who played Loretta and who said she had no qualms about the material. "He's someone you want to strangle."
If we were to categorize the various forms of cancer comedy, the huge majority would fall under the category of bewildered yawps in the face of tragedy, be those yawps bathetic ("Terms of Endearment") or thorny ("Curb Your Enthusiasm").
But two other categories suggest themselves as well. Though graced with a wonderfully sweet boy-girl romance, "50/50" is, like the comedian Tom Green's 2001 cancer special on MTV, a spiky elbow in the oxygen tent, decidedly more graphic and blunt than other works. In Mr. Green's special, one of the comedian's colleagues held up Green's dissected testicle in a plastic bag and compared it to chicken.
Similarly, in "No Cure for Cancer," a stand-up routine on Showtime in 1993, the comedian Denis Leary said he craved throat cancer because "you can make a lot of money with a voice box."
A third type of cancer humor freights the experience with glamour, sprinkling the medical trauma with the pixie dust of positive thinking and Manolo slingbacks. Marisa Acocella Marchetto's graphic memoir, "Cancer Vixen," recounts a "fabulista life" of a girl-about-Manhattan.
Kris Carr, who made the documentary "Crazy Sexy Cancer," espoused the worldview that "cancer needed a makeover and I was just the gal to do it!" The glamour quotient needn't be clothing-related: we also see the tendency in the max-your-credit-card whirlwinds of "The Big C" and the films "The Bucket List."
It's the rare cancer patient or survivor who would protest the wealth of cancer comedy out on the cultural landscape. As Ms. Bicks said, "The larger message here is, 'Don't wait to get sick to figure out what makes you happy' " — a message that most people, regardless of their health, want and need to hear.
That said, those works that fall into either the graphic or the glamorous categories often incite criticism. "When I saw the ad for '50/50,' I thought, 'Do I have to watch that?' " Ms. Sweeney said. "Or 'The Big C.' I love Laura Linney. There are so many aspects of that show I'd love. But I watch that show in real life."
"I saw the pilot of 'The Big C,' where Laura Linney's character chose not to get treatment," Ms. Marchetto said. "That bugged me. She's so full of life and she chose not to live."
Mr. Rakoff takes exception with the "crazy sexy" ethos. "It seems like the oncological chapter of the covert war on women," he said. "Often preached by women against women, which is often just a variant on the pressure on women to not get epidurals during pregnancy and die in labor like in the Victorian age. It sounds like, 'You should go to chemo in sky-high Jimmy Choos!' And if you don't you're a lazy bitch who deserves to die of cancer. It's like, 'Why aren't you wearing purple and stuffing dollar bills into some guy's jock strap in Dubai?' Because I don't feel very well, thanks."
But in the end, criticism of any particular cancer comedy may simply be a sign that the work in question has achieved one of its main goals: to get people talking.
"Anytime you put yourself out there and expose your vulnerabilities, you're adding to the conversation," Mr. Reiser said. "I hope people take away the idea that there's no right or wrong way to respond to the disease. We all screw up."
Indeed, it's only through talking that this sometimes-volatile vein of humor can achieve its more counterintuitive goal: heedlessness.
As Mr. Rakoff put it, "One of the most heartening things to me when I thought I was going to lose my arm was that, whenever the topic of that morning radio show 'The Takeaway' came up, people would say, 'I hate "The Takeaway!" ' Whereupon I'd say, 'Well, you know the host, John Hockenberry, is in a wheelchair because of a car crash?' And they'd say, 'I don't care.' I thought, That's where you want to get to: 'I don't care if he has one arm. I hated his last book!' That's where you want to be."
