Reviewed for Musical Theatre Review:

“That would make a cracking musical.” Director and writer Bryony Kimmings is a looming presence throughout A Pacifist’s Guide to the War On Cancer, the National Theatre’s new musical, produced in partnership with Complicite.

Kimmings opens the show with a voiceover, setting the scene as her musing on how to create a performance piece about cancer might work, her ideas taking form on the stage, and summarising it with the above line as the show’s fiction comes to its conclusion.

Our guide through a hospital’s oncology department is Amanda Hadingue’s Emma, waiting for her baby son’s test results and finding herself caught up in everybody else’s stories while she reassures herself about her boy’s health.

And as a straight exploration of the people whom cancer touches, how they deal with it (or not) and the shifts it can cause in their relationships with family and friends, Kimmings and Brian Lobel’s book touches on not unfamiliar ground.

The perception that smokers with lung cancer are somehow less deserving patients than other forms of the disease, for example, or a man’s struggles to keep his pushy mother from injecting herself into his discussions with his oncologist.

These segments are entertaining – helped by a strong ensemble cast which brings a sense of roundedness to each character from the simplest of authorial strokes – but it is the presentation that prevents this show falling into earnest confessional.

Some lively ensemble numbers keep the energy levels high throughout Act I, with Tom Parkinson’s music and Lizzie Gee’s choreography jumping from busy street to Kafka-esque moves from waiting room to waiting room and all points beyond with a breezy, if straightforward, air.

A medical explanation of cancer cells and how they develop into tumours – perhaps a necessary monologue, but one which could bring a show’s momentum to a halt – is rendered entertaining by being delivered by Amy Booth-Steel dressed as a glittery tumour. Such walking personifications of carcinoma recur throughout, hanging around some characters much as Christian’s burden in The Pilgrim’s Progress.

As Hadingue engages with each of the ensemble’s characters, some real stars begin to emerge. Naana Agyei-Ampadu’s soulful voice and Golda Rosheuvel’s disco diva number stand out, and Rose Shalloo’s moving solo marks her out as a performer to watch in future.

As Emma’s son is whisked away for an emergency biopsy and his mother finds herself pulled into a nightmare of her own growing fears, the show begins to become more and more abstract.

Lucy Osborne’s set design – initially all bare walls and swinging doors – begins to be adorned with large, misshapen balloons, encroaching upon the cast’s space.

Act II opens with Hadingue alone, waiting for news of her son in the early hours of the morning after a sleepless night, the sounds of a world waking up amplified to painful levels.

It is odd for a musical for one of the show’s most powerful moments to be a scene with no dialogue or movement, but it presages the show’s move away from conventional musical form.

Emma’s meeting with her son’s oncologist to receive his results is played out in mime, for example, with sound effects overlaid by other cast members, and the cancer specialist’s voice played out as a booming bass mumble, as if Charlie Brown’s teacher had shifted careers.

And then Kimmings’ voiceover, which had punctured the fourth wall at the show’s opening, returns to tear it down. Hadingue enters a dialogue with Kimmings, in which the factual origins of all the people her character encountered are revealed with the actors lip-syncing to recordings of the men and women they have been portraying.

Rosheuvel delivers the show’s final big solo, the incredibly moving ‘Silly Girl’, but it is in ordinary people talking about their illness, their hopes and fears, that becomes the show’s defining moment.

And while an ensemble reprise of ‘Fingers Crossed’, a number which embodies the show’s best mix of fear and hope, love and loss, leaves the audience with lifted spirits by the end, it is the non-musical elements which resonate far longer after spilling out into the cold Thameside evening.

Judged by its musical elements alone, A Pacifist’s Guide to the War On Cancer would be of mild, ineffective interest; as a complete piece it is far stronger and more powerful than one could believe.