A 62-year-old cancer survivor was recently temporarily denied entry into the US because the treatment he had been receiving had wiped out his fingerprints.

The patient, Mr S, had been taking the chemotherapy drug capecitabine for three years to prevent recurrence of his nasopharyngeal cancer following successful treatment of the disease with another chemotherapy regimen.

Capecitabine can cause inflammation, peeling, bleeding and blistering of the palms of the hands and soles of the feet, a side effect known as plantar-palmar syndrome.  Interestingly, survival is significantly better in patients on capecitabine who experience this severe plantar-palmar syndrome.

The case report of Mr S, published in Annals of Oncology, states that the patient had grade 2 plantar-palmar syndrome that did not affect his daily activities and function. He was not aware that he had lost his fingerprints when he set off from Singapore to visit relatives in the US.

According to the case report, Mr S “was detained at the airport customs for four hours because the immigration officers could not detect his fingerprints. He was allowed to enter after the custom officers were satisfied that he was not a security threat”.

The patient’s oncologist Dr Eng-Huat Tan, senior consultant at Singapore’s National Cancer Center, advises that all patients who are receiving capecitabine carry a doctor’s letter with them when they travel, as doctors are not sure which patients on the drug will lose their fingerprints or when in the course of treatment this will occur.

“Patients taking long-term capecitabine may have problems with regards to fingerprint identification when they enter United States’ ports or other countries that require fingerprint identification and should be warned about this”, writes Dr Tan. “There may be a growing number of such patients as Mr S who may benefit from maintenance capecitabine for disseminated malignancy. These patients should prepare adequately before travelling to avert the inconvenience that Mr S was put through.”

International airports in the US have been fingerprinting foreign visitors since 2004 under the US-Visit (US Visitor and Immigrant Status Indicator Technology) security system. At least two index fingerprint images are taken from all foreign visitors, including those from countries in the visa waiver scheme such as the UK, which are matched with millions of records to detect whether the visitor is attempting to use fradulent identification. These fingerprints are also matched to a list of known or suspected terrorists, criminals and immigration violators.