It is more than just a few mutations. A good number of the common earlyish driver mutations are in the systems that detect and repair damage to DNA, which then

It is more than just a few mutations. A good number of the common earlyish driver mutations are in the systems that detect and repair damage to DNA, which then accelerates mutation accumulation. (At some cost to stability of that lineage, but overall there are obliviously formulas that work) And I’d also point out that these functions that are “sought after” by cancer are not all de novo, some things are complex functions that encoded for use by other normal cells at a other times and places in development of the organism. Some key mutations that enable the use of those functions by the cancer are crucial moments cancer development. Also many key mutations are loss of functions, which are often easier to accumulate. A example of genetic Losses of function is losing “contact inhibition” where normal cells stop growing when they get neighbors. Cancer cells loose this inhibition and just continue growing. This alone would require a suite of mutations. Another comment in the thread talks about cancer evolution and the good of the organism not making sense. Cancer doesn’t care about the organism. The organism has evolved many layers of checks and balances that can work for decades, but throw in time and poisons like smoking, UV damage, and there will be loopholes found. Cancer is persistent and has the entire genome of functions to turn on and off in various ways. Seriously Fu*k cancer.