First you take a lovely boat trip through stunning limestone scenery. Pass one pagoda before you get to the end. Take the cable car to the top and walk down unless you're really in good physical shape. Stop before you get to the cable car for a vegetarian lunch inside the temple grounds - gets you in the mood for what's to come. From the top, it's a short walk to the cave. I suggest reading up on it before you go, as it adds to the reverence that the locals have and why it's an annual pilgrimage spot for tens of thousands of VIetnamese. The only negative is walking along the gauntlet from the dock, where you have to pass through dozens of vendors selling all sorts of "exotic" meats - though there is religious significance to this, as well. It's worth visiting and you'll get to enjoy some of the beautiful countryside along the way.
If your budget allows, you'll get a lot more out of this by taking a private tour rather than one of the many "hurry up so we can get back to Hanoi" group tours.
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