The potential of AI for adjunctive supportive care in cancer survivorship: opportunities, challenges, and the PRECISION-AI practical framework.

Among the 18 million cancer survivors in the United States, many report significant unmet physical, psychosocial, and practical needs that existing healthcare systems struggle to address at scale. This conceptual perspective examines how artificial intelligence (AI)-powered platforms can serve as adjuncts to care by addressing unmet needs, supporting symptom management, and delivering psychoeducation and psychosocial support. Drawing on evidence from oncology AI and cancer survivorship, we consider how AI may improve the quality, personalization, and accessibility of care, distinguishing applications supported by prospective evidence from those that remain in early stages. Preliminary evidence suggests AI has the potential to deliver personalized psychoeducation, symptom monitoring, and psychosocial support as adjuncts to clinical care. To guide responsible development and implementation of these tools, we propose the PRECISION-AI Adjunctive Supportive Care Development Framework, a systematic model for developing, validating, and implementing AI in supportive oncology care. As a primary case example, we describe My Wellness Support, an agentic AI-enabled, risk-stratified supportive care platform designed to augment standard survivorship care, including its conceptual framework and development, ethical considerations, data protections, transparency, and bias mitigation. A proof-of-concept study in breast cancer patients is currently underway. Outcome data are not yet available, and no effectiveness or safety claims are made for the platform. AI in cancer survivorship has potential to expand access to survivorship support and improve health-related quality of life, but realizing this potential requires rigorous prospective validation, equitable implementation across diverse populations, and sustained collaboration among healthcare providers, developers, survivors, ethicists, and policymakers.