Illustration of the concept of driver genes, driver mutations, and structural impact. (A) Cancer involves dynamic changes in the genome caused by alterations such as mutations, epigenetic changes or chromosomal rearrangements. These alterations occur in driver genes that are divided into oncogenes, tumor suppressors, and dual role genes. Oncogenes normally promote cell growth, whereas tumor suppressors normally limit cell growth. The dual role genes exhibit both tumor suppressive and oncogenic behavior depending on the cellular context. The alterations lead to gain of function of oncogenes and loss of function of tumor suppressors which leads to uncontrolled cell growth and cancer. (B) Mutations can be categorized as passengers and drivers. Passengers are characterized by the absence of pathogenic impact. This can be due to their placement away from functional sites of the coding region or regulatory elements in the non-coding regions or the nature of the resulting amino acid substitution. (C) Genes are translated into proteins, and potential alterations including mutations are thereby also expressed. Understanding how these are expressed can give a mechanistic understanding as to why a particular alteration may give the cells a growth advantage. The top panel illustrates the healthy process of interaction, while the bottom panel illustrates some of the structural expressions of driver mutations.