Is there no end to the irrational prejudice against Red Ryder and his peacemaker?

Ralphie, in undoubtedly the best Christmas movie ever (A Christmas Story, and yes, I like it more than It's A Wonderful Life), utters these words after running into roadblock after roadblock on his quest to acquire an official Red Ryder carbine action 200-shot range model air rifle with a compass in the stock and this thing that tells time.

At each step, Ralphie is told "You'll shoot your eye out, kid."

I'm feeling a lot like Ralphie these days. Over the past several months, as I've related, I've been on a quest to get a specific radioimmunotherapy treatment known as Bexxar. And yet, every step along the way, I've been blocked by...well, you name it. First, I was enrolled (and then disenrolled) from a clinical trial. Then, I was stymied in my daily quest to find other clinical trials using the Bexxar therapy as a single agent. Then, I decided I wouldn't be able to get it in a clinical trial, and so pretty much gave hope I'd get it all--it's not often approved by insurance companies as a first-line treatment.

But then it was, and everything was back on track again.

Yesterday, though, I received a call informing me that the FDA requires an additional scan to be performed for any patient receiving Bexxar off-trial. That's me. And, although my cancer center has performed the treatment several times, they've never done it for anyone off-trial; the equipment they need to perform that scan has been ordered. Long story short: it will be about six months before they have the equipment installed. Now waiting six months is probably not a big deal in my case--I have slow-growing disease--but there is a practical reason for wanting the treatment sooner rather than later: I've met my deductibles and out-of-pocket expenses for the year. If I get it before the end of the year, it will be covered at 100%.

Of course, there's another radioimmunotherapy treatment, called Zevalin, which my local cancer center has done many, many times. And to tell the truth, when I've brought up the idea of radioimmunotherapy, the oncologists and specialists I've visited with have nodded, agreed it's a good therapy, and told me they'd do Zevalin.

Based on the evidence, efficacy-wise, it's hard to say there's a difference between Bexxar and Zevalin. It's like Coke vs. Pepsi, in some ways: both are colas, and when you give them to people who are blindfolded, they often have a hard time telling them apart. I know all that. I really do.

And yet, I feel like Ralphie asking for his Red Ryder BB Gun, only to be told "How about a nice football?"

Once again, I have no proven reason to prefer Bexxar over Zevalin. But I have gut instincts that tell me Bexxar is a better match for me specifically. I have theoretical reasons why Bexxar is a better choice (its radioactive isotope has a shorter wavelength, which is probably better-matched for low tumor burden, and it delivers a longer, lower-energy dose of radiation to the body to mimic total body irradiation--which I feel has a better chance of working in my case). Bexxar has been studied specifically as a first-line treatment, and overall, has more clinical trial data behind it.

So overall, I'm not saying Bexxar is better than Zevalin; they've both proven similarly effective. I'm just saying, I've done the research, and I'm drawn to Bexxar for my particular case at this particular time; in other situations, I honestly believe the Zevalin would be better. But for me, right now, I've just gotta go with the Bexxar. I called it a gut feeling before, and I'm not one to just discount that.

But the thing is, if I want Bexxar, I'll have to travel after all. Probably to Nebraska. And, I'll have to stay in isolation for a few days before traveling back.

So it would be easy to just say, "Yes, let's do the Zevalin right here in Billings." After all, in many ways, Zevalin is easier to administer, and its radiation doesn't escape from the body; with Zevalin, I wouldn't need to take any special precautions to stay away from friends and family for a few days--unlike Bexxar. And I'd have the treatment--and be done--in ten days, just a few blocks from my house.

But it's not the Red Ryder BB Gun, is it?

And so, I'm telling my medical team I'll be leaving for a trip--perhaps back to Nebraska, where they've administered Bexxar many times.

I don't want to settle for the football. I'm gonna get my hands on Red Ryder's knurled piece of weaponry.