Just got back from my first follow up after 4th line chemo to learn that my markers are rising again. It was a shock to say the least as I feel well. My oncologist has said that I will be starting Topotecan asap. This is the last drug they can try. If it works they can re challenge me with previous drugs but if it doesn't it's palliative care. He has said that if I get an obstruction they will have to stop chemo. This is very frightening as I've been in and out of hospital with bowel blockage. I am absolutely gutted. Only finished 4th line chemo first week of June. I am relatively calm, is it just denial that this could be happening again so soon. Please could anyone who has used Topotecan share their experiences and whether it worked and how long remission was.