I had my chemotherapy at an NCI designated center of excellence that was a high volume center for treating pancreatic cancer. I wanted the higher level of expertise of oncologists whose sub-specialty is pancreatic cancer. That is rarely if ever found at a local, small clinic. I traveled 4'20" round trip to get my chemo every 15 days to treat stage IV disease. And 11 years later I have no regrets in investing the time traveling to and from the center of excellence to get my infusions.

Over the years I have mentored many pancreatic cancer patients. One in particular wanted infusions close to home rather than a 3 hour round trip to the pancreas center where she had a distal pancreatectomy and splenectomy. So she chose a small medical center near her home and was started on Folfirinox. She had severe reactions to it and by the fifth infusion, ended up in ICU for several days and a lengthy hospital stay requiring physical and occupational therapy. It turned out the head of oncology who was overseeing the treatment had no experience with the Folfirinox regimen. With each infusion and side effects and adverse events occurring, the oncologist never lowered the dosage. When one's life depends on getting the best possible care, it's but one reason why I prefer going to a high-volume center despite the inconvenience of travel.