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Travel & timing after local recurrence
Hello. I have appreciated people's openness and support on this site. This is my first time posting.
My 64-year-old husband was diagnosed with PDAC in March 2025, had Whipple surgery that month (clear margins, moderately differentiated, small tumor, but 5 lymph nodes positive for cancer). Starting in April 2025, he had 6 months of often-brutal folfirinox treatment (with doses of some agents modified as treatment progressed, and the oxaliplatin discontinued after 5 rounds due to bad neuropathy), with chemo ending Sept 2025.
He has been working hard to rebuild his strength, has regained weight, is doing 90 minutes of intense biking indoors--soon to try outdoors, and overall, except for neuropathy in his feet which makes it hard to walk long distances, is feeling well.
A few weeks ago, routine monitoring found an elevated CA 19-9 and he subsequently had CT scans (earlier than had been planned). While the chest CT was clear, the abdominal CT found evidence of a local recurrence in the surgical area. He has no symptoms.
He is scheduled to have SBRT (strong, targeted radiation to the area of recurrence) for 5 days, starting in a few weeks (the earliest that the fancy machine at Dana Farber here in Boston is available). He then will have scans and CA 19-9 testing every 2 months.
We've been told to expect further recurrence and then progression from there, which could happen soon or could be a little while. (Wish we had a crystal ball.) At that point he would most likely need to go on gemcitamine/abraxane, or maybe some kind of trial.
His favorite thing to do is to travel places off the beaten track, preferably with loved ones. We would like to go on one more "big trip" with our young adult kids and their partners. The best time for the 7 of us to get away together is late December.
We are considering going to Tanzania for a safari. (We're also looking at going on a Galapagos trip... my husband would like to go to Southeast Asia…Morocco...we're fairly well-travelled...open to ideas).
We would purchase extensive travel insurance, and go where we would be able to get to a hospital in a city within a few hours, and would get insurance that would allow him to be medically evacuated if necessary.
Is this a crazy idea? There's a reasonable chance that by then he will be on systemic chemo. Has anyone done any big travel along these lines while on chemo? Anyone have experience with living disease-free/progression free following treatment for local recurrence? Should we book the trip?
Advice, experiences, ideas are welcome. Thank you.
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A few thoughts that might help as you think it through:
• Travel during or between treatment is possible — many people do travel on regimens like gemcitabine/Abraxane, often timing trips between cycles when energy is better
• The biggest considerations are access to care, infection risk, and flexibility
• You’re already thinking the right way with travel insurance and evacuation coverage
One thing I would add — really read the fine print on travel insurance. It can be helpful, but it doesn’t always cover what people think, especially with pre-existing conditions.
Also keep in mind that in more remote or developing areas, doctors may not be familiar with the nuances of pancreatic cancer care, so access to the right kind of care can matter as much as access to any care.
On Morocco — yes, major cities like Casablanca and Marrakech have international airports with runways long enough for large jets and access to advanced medical facilities. The key is staying within a reasonable distance of those cities if that’s a concern.
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4 Reactions@bblz
I would second all that Mfrancis wrote. It sounds like you all are accomplished travelers so you may know this but absolutely read small print on travel insurance. I am a stage 4 patient since 2021, on and off chemo, trials, etc. a few months NED then a reoccurrence. My bike trip to Chile in November had to be cancelled. I took MONTHS to get $$ refunded. All good at Delta but the trip-another story!
I noted you will do CA19-9 every two months? Hopefully you meant every two weeks as I do. It’s about the trend, not one reading. Also, pls ask for the Signatera test. It will alert you on circulating cancer DNA, even when no tumors can be seen.
We too are pondering a safari in Sept to celebrate a big milestone!
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7 Reactions@bblz I am about to go on a trip myself and I am taking with me the contact information of my head doctors in the event of needing urgent care while traveling. I will also carry a hard copy of the procedures I have had. This may be the fastest way for an ER doctor / surgeon to learn what treatments / surgeries one has gone through.
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3 Reactions@mcharlesfrancis thank you.
@gamaryanne it's heartening to hear that you, too, are considering a big trip. Hope it works out well for you!
My husband's doctors feel that at this point, it doesn't make sense to track CA 19-9 more frequently. He will have 5 days of MRI-guided SBRT, and we've been told that that treatment is likely to keep his CA 19-9 elevated for 1-2 months due to the inflammation/ irritation caused by it, so no actionable information would be gained from CA 9-9 tracking until 2 months later. And since this is a local recurrence that they hope to address with the radiation, they don't plan to track CA 19-9 more frequently (unless/until they find something on the ground very--month CT scans). I'm sure things will keep getting adjusted as things change with his disease.
Thanks for writing.
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3 Reactions@carfbuch thank you. Yes, we always have the oncologists' contact info and access to my husband's medical record with us--I agree it's a good habit!
@bblz, have you decided where and when to travel?
It's time to start asking about Histotripsy, especially for new diagnoses. Histotripsy is approved for liver cancer, pancreatic cancer Histotripsy under clinical trials.
Your plan sounds lovely! So special to be just grabbing life and going all in. You have a plan. Sure things might sway a bit. Or maybe have to return home. Im excited for you all. I know my husband's journey is just staying close to home. Simple relaxing moments. Reach back & let us know what you've decided. No matter the desition there are memories to be made.
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2 Reactions@colleenyoung
Not yet, in terms of a big Dec trip.
We've planned some smaller trips in the shorter term--heading to the New Orleans jazz festival a few days after radiation ends, for example. Going to friends' place on Cape Cod and to the Berkshires. Visiting family in NYC. All easy to cancel.
Considering a trip to the Azores in July/August.
Really hope we can do a big family trip in Dec when all the kids/partners are available but need to learn more about how we'd handle a medical emergency, and to check travel insurance terms, before investing in a once-in-a-lifetime experience for 7, like a safari. Probably 50-50 that he'll be up to it. But travel is what he loves so we will try to make it happen.
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4 Reactions