The only Sicily day was Messina. The Etna tour is hours of driving so we didn't do that. Etna is erupting a little right now so you can see it from far away but it might be cool up close. We hated the messina excursion we did. It was mainly seeing places where they filmed the godfather. We would have stayed on the boat if we had known. Olympia is ruins that are mainly 2 feet high. Ephesus and Rome are ruins that tower above your head so they are much more interesting to me. If you are not up to TONS of stairs, certain ports will be very hard on you. I recommend signing up for an excursion on line before the trip for each port that you want to go into. You might pick one of them to skip (it is exhausting). Some stops we had to use a tender boat, which meant you had to wait your turn. This could take 20 minutes or 2 hours. The people on scheduled tours go first (once again I would sign up for these even though they are of variable quality). The stops that don't use tenders, you can get off quickly. Within 30 minutes of docking being complete. Normally you have to be on board the ship (or the last tender boat) 30 minutes before departure. San Torini was the absolute highlight of the tour. Schedule as much as you can there and consider skipping or limiting one of the days before if you think you won't have the strength. Try to budget some time in Rome before or after the cruise if you haven't been there before. Rome was the second best stop after San Torini. Malta was kind of cool. Lots of shopping in Rome, malta, San Torini, etc. Ephesus tours end with a carpet sales pitch. I just walked away.