Of Course Cancer Isn’t Random

We might say, I suppose, that ships sink randomly because ships tend to sink in storms at sea, and storms at sea are not under our control. The analogy with cancer is fairly robust. Storms at sea are random to a degree, but we also know where, and in what season, they are most common. Similarly, we know about social, environmental, and lifestyle factors that favor mutation, and impair immunosurveillance. More importantly, although any ship is more likely to sink in a storm than in fine weather, the likelihood of shipwreck varies, of course, with the competency of captain and crew, and the seaworthiness of the vessel.