Irinotecan and topotecan are chemotherapies we have in the family of camptothecins. It’s actually a natural product. So when people say “I want natural therapy,” it’s something that we find in a Chinese tree called Camptotheca acuminata. And these drugs are used in several different cancer types. Topotecan specifically is only used in small cell lung cancer and ovarian cancer, and has some unique features that are different than its cousin irinotecan. It can cause a flu like syndrome the day that you get your chemotherapy treatment. Also, it needs to be renally dosed, so we need to know what your kidney function is and make sure you keep up on your fluids during therapy, because it depends on them for clearance. It can decrease your neutrophil count, which is what fights bacterial infections, and is part of your white blood cell count. And it can cause some mild nausea, as well as some diarrhea or a skin rash. If these things occur, just gauge how pronounced they are with each treatment and let your doctor know.