@susan2018 At this the plan is to check .CA 19-9 monthly. In February at Mayo it was 164. In Sioux Falls in June it was 86. At Mayo in July it was 126. The jump from 86 to 126 sounds like too much just to be a difference in labs. It will be interesting to see what it is in Sioux Falls next month. My understanding is that typical treatment for recurrence is radiation and chemo. I was told that radiation alone has a 30% success rate and radiation and chemo together have a 40% success rate. With my kidney problems, if I did chemo I would also have to do dialysis. To me, the added benefit of chemo was not worth the extra requirement of dialysis. I will be going back to Mayo for another PET/MRI scan in October. We will have a better idea of future treatment after that. Last February, I had an EUS/biopsy done and I consumed with a surgeon who told me that surgery was not an option for me.