I can't speak to your specifics, but can describe my own situation. I am stage 4, with no node involvement but several small mets visible when I had a staging laparoscopy in early April. Because of the mets, I do not qualify for any type of radiation or surgery. So far, I've completed 14 chemo cycles. We have decided that I'll continue as long as I want or as long as I'm getting results; when results start to lag, I can switch regimens and, later, look for a trial if I want.

My first eight cycles were Folfirinox. The first was at 80 percent of typical dose (reduced because I'm over 70, and the oncologist pointed out that the full dose was tested on people much younger than me); all other doses have been at 60 percent of typical due to the rough reaction I had to the first cycle. Beginning with cycle 9, the oxaliplatin was dropped from my regimen. My oncologist said that he prefers discontinuing it before neuropathy gets so bad that it's permanent and crippling. Please note, and this is sort of a reply to another post on another thread, we are not really striving for a cure, given my age; we're working toward stable disease and length and quality of life. I'd take a cure! But no guarantee it'll happen.

Having described all that, I can tell you that my CA 19-9 has gone down steadily since it first was taken in mid-March. I started at 1736. The most recent CA 19-9 for which I have a result is 35. It was taken before chemo no. 13 on 11/14, so it represents four cycles minus oxali. So, in answer to your question, in my case dropping the oxaliplatin didn't cause an increase in CA 19-9. But I'm only one patient. Pancreatic cancer tends to respond to platinum-based drugs, and omitting it may be linked to the rise in your CA 19-9. Many factors can make it go up, but those of us with pancreatic cancer are sensitive to an increase because yes, it can indicate a recurrence. So I would ask my oncologist to pursue a cause for that increase, in case something has developed that needs to be treated. I hope you can find the cause!