Bglass – thanks for the response> It was VERY helpful. And, took a little edge off the anxiety of the increasing CA-19 numbers my brother has been receiving. We all just need to be patient to see what the imaging shows. My brother was diagnosed with stage IV right off the bate at 50 years old. He is young, healthy, and his Oncologist DID say they were going to be very aggressive with the treatment (hence, Fulfirinox), which totally makes sense from what you explained above. When first diagnosed his CA-19 was 5300. After cycle ONE it was 6,500, after cycle TWO 9,400, and after his cycle THREE 9600 (only a 200 point rise this time). Even though it rose again, we were all delighted to see it did not rise AS MUCH! His oncologist did tell us not to get too hung up on these numbers and said exactly what you did about going by how you’re feeling, and imaging. His bloodwork as far as liver enzymes, kidney function, etc. has been excellent. He is tolerating the Fulfirinox quite well!! Fatigue and some neuropathy are his biggest issues. We are all being optimistic and pray for a good scan on June 21st! Thanks again for the input.