Mutations are the primary drivers of cancer evolution. These genetic alterations can occur spontaneously or be induced by environmental factors like carcinogens, radiation, and viruses. Mutations can affect oncogenes, which promote cell growth, or tumor suppressor genes, which inhibit it. When mutations activate oncogenes or inactivate tumor suppressor genes, they can lead to uncontrolled cell division and the formation of tumors. Over time, additional mutations can create a diverse population of cancer cells with varying abilities to adapt to different environments within the body.
