In "Stepmom," Susan Sarandon's character is informed that an undefined cancer has spread, necessitating chemotherapy. Fearing that the news will upset her children and her ex-husband, she keeps it to herself until a plucky Julia Roberts squeezes the news out of her.

Though such an approach leads to movie drama, it doesn't jibe with reality, according to Dr. Anne Coscarelli, Ph.D., director of the Rhonda Fleming Mann Resource Center for Women with Cancer at U.C.L.A. "When people get diagnosed with metastic disease, it's devastating," says Coscarelli. "People have a very difficult time psychologically when their cancer recurs, so most share the news with close family and friends. Plus, it would be extremely hard to hide the news from people you were living with."

Hollywood is notorious for glamming up actresses in such scenarios, but Sarandon's character exhibits few signs of deterioration as her illness progresses -- other than fatigue, nausea, and some pesky dark circles under her eyes. "In advanced cases, most people lose weight, go bald, even have changes in the color of their skin," says Coscarelli. "And while not everybody loses their hair, if a woman had metastasized breast cancer, she most likely would."

Perhaps most unrealistic is Sarandon's grace under pressure. Though her unflappable calm makes for a more sympathetic character, it's unnerving how easily she accepts her own demise. When alternative treatments overseas are suggested after the last round of chemo fails to take, she instead opts to spend her remaining days sewing quilts for her children and smiling beatifically. "Wouldn't it be nice if we could all deal with death so easily?" asks Coscarelli. "But few patients make the choice to stop being treated, even if it seems unrealistic."

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