The current issue of the Annals of Oncology carries the story of a cancer patient from Singapore who met with detention as a suspected security risk when he arrived at an airport in the United States to visit relatives in December 2008.  The 62-year-old cancer patient, whose name has been withheld for the sake of privacy, had been taking the drug, capecitabine, to minimize the risk of recurrence of cancer.  One side effect of the drug is chronic inflammation of the palms of the hands and soles of the feet.  In this particular case, the inflammation resulted in peeling skin on his hands that had completely peeled away his fingerprints, too.

Almost everyone traveling to the US must be fingerprinted at their point of entry.  This law applies to most non-US citizens between 14 and 79 years of age.  The cancer patient from Singapore was held by immigration officials for four hours before getting permission to proceed with his travel plans.

The traveler’s doctor, Tan Eng Huat, a senior consultant of medical oncology at the National Cancer Center in Singapore, says capecitabine is often prescribed for cancers that affect the head, neck, breast, stomach, and colorectum.  The patient had suffered cancer of his neck and head, had successfully undergone chemotherapy treatments, and has been taking capecitabine for more than three years to prevent recurrence of his cancer.  It was Tan who reported the incident to the Annals of Oncology.

Tan says loss of fingerprints is not included in warnings on the drug’s label or literature to physicians but the risk of developing hand-foot syndrome is listed.  This syndrome is described as chronic inflammation of the palms or soles that can cause the skin to peel, bleed, or become blistered and ulcerated.  The chronic peeling of the skin on the patient’s hands made his fingerprints disappear.

According to Tan, the theory stands that fingerprints will grow back if the drug is stopped but the data on disappearing fingerprints is so scarce it is impossible to say how long a patient must take the medication before fingerprints peel away or how long it takes them to return once the drug is discontinued.

In the meantime, Tan suggests anyone taking capecitabine should travel with a letter from his or her physician, especially when traveling to the United States.