Movies focusing on adult female friendships are rare these days and those that do get made usually rely heavily on raunch in order to appeal to a younger demographic. But Catherine Hardwicke's unflinching, unadorned examination of two thirtysomething BFFs living in London takes a refreshingly more mature approach. It dives deeply into the messy undercurrents of friendship, where love and loss, hope and despair forge inseparable bonds that aren't easily broken. It is also a candid cancer drama that is as funny as it is heartbreaking. Miss You Already begins at the end. In the opening scene, we meet Jess (Drew Barrymore), who is in agonizing labor and screaming that she wants Milly (Toni Collette), her childhood pal since grade school. But Milly has cancer and may not have long to live. The movie then shifts into reverse and traces the course of Jess and Milly's full-blooded friendship. In an information-stuffed montage, we learn that when the duo were in their twenties Milly married a rising rocker (Dominic Cooper) and gave birth to a son and daughter, while Jess moved in with her blue-collar boyfriend (Paddy Considine) on his boat and struggled to conceive. Milly also is diagnosed with breast cancer. What follows is a painfully honest look at how Milly's declining health and her reaction to it impact her family and her friendship with Jess. Screenwriter Morwenna Banks was inspired to write about the effects of cancer on friendships when three of her friends died of the disease within a short period of time. She first wrote Goodbye, a much-praised radio play, and then adapted the story for film. Her unsparing gaze doesn't shy away from cancer's ghastly effects, but she balances the horror with liberal doses of much-welcome humor, and isn't afraid to shine a spotlight on her characters' deepest flaws, especially Milly's. After undergoing a double mastectomy and finding intimacy difficult with her husband, Milly flings headlong into a brief affair with a young bartender (Tyson Ritter). Her impulsive decision is off-putting and it severely strains her friendship with Jess, who calls her a "cancer bully" for the increasing level of selfish behavior Milly exhibits and thinks she's now entitled to, which also includes publicly berating her hubby for throwing a surprise birthday party in her honor when she just wanted to be alone. But Milly's mistakes, while repulsive, make her all the more recognizable and relatable. Hardwicke, best known for helming Thirteen and Twilight, directs with razor-sharp, unblinking focus. She favors close-ups and not only of her actors' faces -- there are raw shots of needle insertions, vomit projections, and mastectomy scars. These are brave choices that force us to confront the awful reality of cancer, but the filmmakers don't dwell on them and never allow them to overwhelm the story. Of course, these blunt images wouldn't be affective without rich, full-bodied performances to back them up. Thankfully, Collette and Barrymore are up to the challenge, with Collette delivering a powerfully modulated performance that swings wildly between delicious delight and dignified despair. When she's onscreen, which is for most of the movie, you can't take your eyes off of her. The supporting cast is equally effective. It's especially fun to see Jacqueline Bisset as Milly's vain mother, a semi-famous actress, who uses her industry connections to get her daughter a suitable wig. The scene in which Milly gets her hair shaved off and her mom quietly picks up a lock of it is especially moving. Miss You Already isn't perfect. It's a bit overlong and bloated in its midsection, and its inevitable conclusion doesn't quite deliver the punch that it should. Nevertheless, have plenty of tissues handy. You'll need them.