Oncology Isn’t Debating AI Anymore. It’s Building It.

Dublin. The 26th Global Oncology & Haematology Congress. Physicians, pharmacists, and industry partners from across the globe, brought together by NCODA [Network for Collaborative Oncology Development & Advancement] to do what this community does best—take the work seriously.

Over the last several months, something has shifted in these rooms. The tone is different. The questions are different. A few years ago, when I started writing and speaking about “Rebooting Cancer Care,” the conversation centered on "whether"—whether the technology was ready, whether oncology needed it, whether the promise justified the risk.

That conversation is closing. Something else is opening.

What I heard in Dublin was not debate. It was urgency, tempered by discipline. How do we begin? How do we bring our teams along without burning them out or leaving them behind? How do we hold these AI tools accountable to patients—not just to the institutions treating them? These are harder questions than the philosophical ones. These questions assume we are already moving, and ask only whether we are moving well.

We are no longer standing at the threshold. We are across it. The work now is to build with the same care and precision that the oncology field brings to everything else—responsibly, deliberately, and without losing sight of the patient in the room.

That shift, from if to how, is not small. It took longer than I expected. Seeing it arrive, in a room full of people who research oncology and treat patients with cancer, was worth the trip to Dublin.

When a room full of oncologists and pharmacists from a dozen different countries stops debating whether AI belongs in cancer care and begins identifying how to integrate and use AI responsibly, that is not a technical milestone. It is a moral one. It is a milestone that means the people closest to this specialty of oncology have decided that the question is no longer theoretical. It means we are building something. And the debate they are having now—the fierce, specific, sometimes uncomfortable argument about standards and accountability and patient safety—is the argument that protects you.

Douglas B. Flora, MD, LSSBB, is Executive Medical Director of the Yung Family Cancer Center, St. Elizabeth Healthcare, in Edgewood, Kentucky. Dr. Flora is Presdident-elect of the Association of Cancer Care Centers.

Disclaimer: This commentary represents the views of the author and may not necessarily reflect the views of ASCO, Conexiant, or ASCO AI in Oncology.