ncteacher I haven’t seen any posts from you for awhile now. How are you? I just noticed this post today and thought I would throw in my 2 cents since this is my issue now. In late June and early July my CA19-9 climbed 2 points from 17 each session (ie 19, then 21). I also had a CT but not MRI (I have liver lesions and abdominal nodules). That CT showed decrease in size of my lesions. I also started to have some occasional sharp pains in my left side. This small increase had me concerned. My oncologist (not pancreatic) at infusion center seemed almost annoyed with me for being concerned as they congratulated me on my CT. I did have a small hernia which they said was new, but of no concern to them. I happened to also be experiencing some cardiac arrhythmias at this time. My birthday was also after mid July so my infusion oncologist put me on a chemo vacation for 1 week but I asked for 2 weeks because I was having some extended birthday celebrations. I feel this was a huge mistake as when I returned my CA19-9 was now 97 (from 21). I had another infusion the following week and my CA19-9 was now 197. It took a bit convincing by me for my infusion oncology to admit that “changes are occurring”. He tried to offer that CA19-9 tests can have different upper limits! Yes, 34 or 37! So now I’m getting imagine next week (PET and MRI) and will meet with my pancreatic oncologist following those imaging results to see if there is a next step for me. So yes, everyone is different, but the first question I would ask myself is has the CA19-9 been a good indicator of your cancer status? For me it always was. Also, there can not only be growth of existing tumors or lesions, but appearances of new modules, lesions, etc. which might have caused that increase in CA19-9.