Amid the long battle children face against leukemia, there’s another wound that often goes unnoticed. A small sore in the mouth that stings every time they swallow water, speak, or even smile. That wound is called oral mucositis, a painful inflammation in the oral cavity that appears as a side effect of chemotherapy. Not only does it cause physical torment, but it also robs children of their basic rights—to enjoy food, sleep soundly, and speak without pain.

 

Now, however, hope is arriving from unexpected places: the ocean and the garden. Specifically, from the body of a sand sea cucumber (Holothuria scabra) and the peel of red dragon fruit (Hylocereus polyrhizus). These two natural ingredients become the main stars of an astonishing study published in the Journal of Pharmacy & Pharmacognosy Research by Timmauli Parulian Gultom and her colleagues. The research team—comprising Siti Salmiah, Zulfi Amalia Bachtiar, Ika Devi Adiana, Gita Wulan Sari, Kerenha, and Deborah Christina Tambunan—from Universitas Sumatera Utara and the Dental and Oral Hospital of Universitas Sumatera Utara, is not only about science. It goes deeper—about how nature, when carefully formulated, can become a gentle and powerful wound healer.

 

“Most pediatric leukemia patients experience mucositis after chemotherapy. This oral cavity wound is often considered a minor side effect, when in fact it is excruciating and slows recovery,” said Timmauli. She voiced her concern not only as a researcher but also as a mother who fully understands how crucial quality of life is during a child’s healing process.

 

In this study, the team developed an oral drop solution combining sea cucumber and dragon fruit peel extracts in three different concentrations: 20%, 30%, and 40%. The subjects were Wistar rats induced with mucositis using methotrexate, a commonly used chemotherapy drug. Each group received different treatments, including a positive control group (treated with hyaluronic acid) and a negative control group (untreated). The treatment was administered twice a day over 3, 7, and 14 days.

 

The results were astonishing. On day three, no significant differences were observed. But by day seven, the groups treated with 20% and 40% concentrations showed complete healing. No swelling, no open wounds. Even faster than the group treated with the standard medication.

 

What exactly is working behind this simple drop? The answer lies in phytochemicals and marine bioactives. Sea cucumbers are more than just exotic food—they contain collagen, triterpenoids, flavonoids, and saponins, compounds known for their roles in cell regeneration, anti-inflammation, and wound healing. Collagen accelerates the growth of new tissue, while triterpenoids help to suppress painful inflammation.

 

Meanwhile, the peel of dragon fruit—often discarded—holds extraordinary antioxidant power. Its content of betacyanin, flavonoids, and tannins helps neutralize free radicals, reduce inflammation, and accelerate the recovery of damaged tissues.

 

“We wanted to utilize fruit waste that is often overlooked. Dragon fruit peel turns out to be rich in active compounds, and its effects are remarkable when combined,” explained Timmauli.

 

Beyond physical healing, this combination of drops also defeats time. The average healing time for the 20% group was 7.33 days, and for the 40% group, only 6.83 days. In comparison, the positive control took 9 days, while the untreated group had not recovered even by day 14. This shows how effective this natural combination is in accelerating post-chemotherapy wound recovery.

 

“What moved us deeply was the histopathological results. The wounds completely closed, new tissue formed perfectly, and inflammation disappeared. These are not just numbers on a table, but real proof that a natural approach can be a genuine solution,” Timmauli said enthusiastically.

 

Although the results are promising, the research team is not rushing to declare a miracle. They acknowledge many aspects still need refinement. For instance, organoleptic tests showed the drops were not yet ideal in terms of viscosity and spreading ability. Some formulations were too thick or did not adhere well in the oral cavity. The next step, therefore, is to perfect the texture to make it comfortable for children to use.

 

The working mechanism is also incredibly complex. Saponins and flavonoids suppress pro-inflammatory enzymes like COX-2 and PLA2. Triterpenoids promote collagen production and accelerate tissue repair. Tannins and alkaloids serve as natural antibacterial agents, preventing secondary infections in open wounds. Meanwhile, betacyanin—the red pigment in dragon fruit—acts as an immune guardian, inhibiting inflammation pathways triggered by the IKK protein.

 

“Imagine, with just a few natural drops, we can target so many biological pathways that contribute to pain and wounds. This proves that science can synergize with nature’s heritage,” said Timmauli.

 

The final recommendation is quite interesting: among the three concentrations, the 20% combination was deemed most optimal. It provided fast healing with efficient use of raw materials. In terms of large-scale production, this is important to reduce costs and improve accessibility. Imagine if this formula could be made available as standard supportive therapy for child cancer patients—affordable, effective, and side-effect-free.

 

This article is not merely a laboratory result. It reflects a new approach in the medical world—combining the wonders of nature with the precision of science. It is proof that within the body of a sea cucumber and the peel of a discarded fruit lies the hope to heal the deepest wounds of young cancer warriors.

 

The hope is that one day, when a child can smile wide without pain after chemotherapy, we’ll know that this drop of life has done its work—silently, lovingly, from nature to humanity.