Distinct genetic and metabolic differences have been identified between the mitochondria of healthy and cancerous cells. These differences encompass changes in the expression and activity of enzymes that play roles in both aerobic and anaerobic respiration, the oxidation-reduction pathways, and the processes of mitochondrial DNA (mtDNA) translation and transcription. Although these phenomena have been extensively documented, the underlying mechanisms that lead to mtDNA mutations and their implications in cancer, drug resistance, and disease progression remain unclear.