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Health, Science & Tech

'Stars' Film Makes Stars, And Friends, Out of Young Cancer Patients

"The Fault in Our Stars," a movie adaptation of a critically and commercially popular young adult novel, has just finished filming in Pittsburgh and in the Netherlands.

The book and movie center around two teenagers who meet and fall in love at a cancer support group. Many of the extras in the movie are young people with cancer.

There’s a lot of buzz surrounding the movie adaptation of the beloved novel. Book author John Green says the story goes against the typical trope popular media brings us about the ailing.

"What bothers me most about the way that we portray people with disabilities and chronic illnesses in television in films is that we ignore them, and then secondarily when they are portrayed, it's usually as a mere tragedy or as this bright-eyed perfect person who you know, is laid-low by this evil disease," he said. "And the true story is much more complicated than that."

Green said characters with cancer are often used in books and movies to teach healthy people important lessons, which is a dehumanizing way of imaging illness to a sick person.

The teenagers in this story are confused and thoughtful and angry, they are sexual and smart and stubborn. They’re typical teenagers — they just happen to be teenagers living with terminal illnesses.

"One of the things that excite me most about 'The Fault in Our Stars' movie is that in every scene in the movie Hazel is wearing a nasal canulla," Green said. "She can’t breathe without this supplemental oxygen. In every scene of the movie Augustus Waters is walking with a limp because he has a prosthetic leg. You don’t see those characters just as tragedies you see them as full people because the movie is devoted to them."

When Shailene Woodley, the actress who plays the lead role of Hazel Grace Lancaster, arrived in Pittsburgh to start filming the movie, she met with Alexander Murph.

Murph, a former class president, board game aficionado and an Eagle Scout, has Ewing’s Sarcoma, a rare type of bone cancer. He’s spent much of the past year having chemotherapy every other week.

"I actually got to meet with Shay before I even went on set," Murph said. "She actually talked to the directors and just wanted to meet some cancer patients. She just came to Oakmont and just hung out for a while. It was really cool."

Woodley had questions in preparing for her role, like "what it's like when you're on chemo, and what it's like when your recovering from chemo," Murph said. "It's like, it's difficult to explain. You’re in a whole different state. You feel sick, you feel weak, you have trouble thinking. It's really quite awful."

The producers of the movie contacted doctors at Children’s Hospital of Pittsburgh to find extras, kids who had experienced some of the same things as the characters in the book. Murph was a perfect fit — while he was on chemotherapy last spring he also starred in his high school musical.

Murph’s cancer was in his hip, and he’s since had five inches of his hip removed. Between filming days, he had the hip replaced with cadaver bone. He now wears a brace and is temporarily in a wheelchair.

Despite the pain and hardship, going from a straight "A" student to barely passing, friends who have distanced themselves, using a bedside commode, Murph calls himself an aggressively social, happy and funny person. His humor has now extended to cancer jokes.

He said he has kept his humor despite all of the things he has gone through in the past year and all he knows awaits him.

"Cancer is a little bit different," Murph said. "I’m reminded of the fact that I have cancer every single day because I’m weak every single day and I have this giant brace attached to my body. But you know, if I were to die — which is a terrible thing to say, I’m not going to die. I’m not going to die — If I were though, I would want these days that I have left to be happy." 

While what 18-year-old Murph is going through is real, "The Fault in Our Stars" is medical fiction. Green said that aspect of the novel required research.

"I did a lot of research about adolescent cancer and specifically about osteosarcoma and thyroid cancer that Hazel has, which is almost always curable, but of course stage 4 cancer is often not, and in Hazel’s case it is not a curable condition," he said. "I talked a lot to oncologists and nurses and families of kids who have had cancer and also teenagers living with cancer themselves."

He also ignored facts whenever it suited his interests as a novelist, making up a medication called "phalanxafor," for example.

But while he may have fudged reality in some places, people who have cancer or are in remission say it is true to emotion.

"Whenever other people who have never been through cancer or have never had somebody associated cancer, they kind of read the book as just a love story, but like I read it as just so much more," said 23-year-old Bethany Leo.

Speaking to a reporter recently, she was fresh off chemotherapy for spindle cell sarcoma – a soft tissue cancer.

"I had heard of The Fault in our Stars," she said. "I mean, being in the whole cancer circle, the kids cancer circle, people are always like, 'Oh you should read this book,' or, 'Oh you should look at this …'"

But Leo hadn’t read the book until she auditioned for a part in the movie.

"I’m really not much of a book reader, but this book I could read over and over again," she said. "I guess I understand it on a different level than some people do."

Even when describing her grueling experience with cancer, including misdiagnoses, chemotherapy, blood transfusions and her PET scan, Leo uses some of the same language character Augustus Waters used in the book when describing her PET scan. 

"I lit up like a Christmas tree, and it was in every single bone in my body," she said.

Leo has a speaking role in the movie — she plays a young woman named Bethany with spindle cell sarcoma in the support group where the two leads meet each other. She said all of the extras in the support group scene were current or former cancer patients. 

"I definitely have more of a connection with these kids than, I’m not trying to say anything bad about any of the main characters, but you know, these people get it," Leo said. "They know it, they’ve lived it they’ve been there. Some of them are currently there."

The film crew was shooting "The Fault in Our Stars" in Pittsburgh for more than a month. It’s a process that required long days that consisted of shooting the same scenes over and over and over again. During those long days Leo said she and her fellow extras entertained themselves.

"One of the fun things everybody was doing was everybody was showing their scars, because usually you get a scar from tumor removal, so one girl has a scar across her neck the one kid has a scar all the way down the side of his head … I’m like lifting up my shirt showing my scar and the one kid he just had a chunk of his hip removed ...," she said.

That kid was Murph, who says they all became instant friends.

"I’m not gonna lie, that was awesome," he said. "I was so happy to meet other cancer patients. There was this one guy, his name was Josh, he had the same kind of cancer I had, he had it in the same place. His metaport is in the same place as my metaport, he is also an Eagle Scout, he is also bald. It was kind of funny, we both suddenly realized that we had all this stuff in common. It was really cool. We’re kind of bros now."

On one of the last days of filming, a scene was being filmed in a bookstore coffee shop. Actor Ansel Elgort, embodying Augustus Waters, is telling Shailene Woodley’s Hazel Grace Lancaster a story. His character’s signature unlit cigarette is dangling from his lips, she playfully reaches over and grabs it from him. In the background extras moved back and forth carrying books and bags.

Because author John Green took creative licenses in creating this story, the film’s producers have met with actual oncologists to make some of the less realistic diagnoses and treatments more realistic. He was reluctant to sell the rights to his story — he didn’t want the story changed — but after meeting with the producers he said the movie is a faithful adaptation. And watching the actors portray his characters has changed how he thinks of them as well.  

"It’s really profoundly weird to have a story that you imagined several years ago become visible suddenly," Green said. "For me, Shailene Woodley has become Hazel and Ansel Elgort has become Augustus and Nat Wolff has become Isaac. Inevitably their portrayal of those characters have been so convincing to me that that’s how I kind of imagine the characters now."

"The Fault in Our Stars" is expected to open in theaters in June. And by then, Alexander Murph hopes to be done with chemotherapy and walking again.