Health awareness

Finding joy after surviving cervical cancer twice

How one woman embraced life, marriage and motherhood despite her cervical cancer diagnosis

September 25, 2025

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Chrstine Granado and her family

Several years ago, Christine Granado was living happily in New Jersey with her fiancé and then-9-year-old son, but she felt something wasn’t right.

In the span of a year, she lost three pregnancies. The first miscarriage came as a total shock. With the second, she felt confused. After the third, she was afraid something was terribly wrong. She decided to go for a routine checkup. While undergoing a series of tests ordered by her OB-GYN, she got surprising news: she was diagnosed with stage IIB squamous cell cervical cancer that had spread to her lymph nodes. At just 28, Christine said she felt disbelief.

“How can I have cancer at this age?” she asked herself. “I remember peeking through my bangs, feeling like I was trying to hide behind them.”

Young women are at risk for cervical cancer, too

Granado wasn’t alone in asking herself that question. Cervical cancer is most often diagnosed between the ages of 35 and 44. In 2022, over 660,000 people around the world were diagnosed with cervical cancer. In 2025, it’s estimated that around 13,000 people will be diagnosed with cervical cancer in the U.S.

Regular screenings can catch early changes in the cervix before they turn into cancer, but not everyone has the same access or risk factors for cervical cancer. That’s why it’s so important to make sure everyone gets the care they need.

Beginning her cancer treatment journey

Granado started treatment as soon as possible. She was prepared for physical side effects but was overwhelmed by the other changes that soon followed, including how she felt about losing her fertility. She and her partner discussed preserving her eggs but decided against it as doing so would have delayed her treatment.

Granado’s cancer went into remission for three years, and she found joy again: She and her fiancé got married and decided to have a baby via surrogate.

The shock of a recurring cancer diagnosis

Then, soon before her son was born, Granado started having unexplained chest pains. A CT scan found enlarged lymph nodes. She was diagnosed with metastatic cancer.

“When I got the recurrence diagnosis, I was devastated. It was hard to hear, but it motivated me to finish things, to contact a lawyer and get things in my kids’ names — to think about life after me,” she said. 

It also motivated her to continue with more treatments. During her second round of treatment, Granado was able to welcome her new son. When she saw him, she took him in her arms: “I bawled my eyes out.” 

A focus on mental health 

In addition to her son’s arrival, Granado said a focus on herself has sharpened her resolve to live her best life. When the cancer came back, she grieved for her life. She would cry and sleep all day. Her depression stopped her from enjoying precious time with her family.

“The most disabling thing I dealt with was the depression,” she said. “There were days when I would feel physically OK, but I’d still stay in bed all day.” Thankfully, Granado had the support of a psychologist and a psychiatrist who helped her feel well again. 

little boy laying with a dog

Cervical cancer won’t stop her from living her best life 

Granado has been able to complete a master’s degree in health leadership, and her family has a new border collie named Harry. Even everyday activities like going to the hardware store and winding down with a book mean so much more now. She appreciates the small details, like watching TV with her son on the couch.

“Life has been amazingly boring,” she says. “In a good way.” 

Granado said she hopes her story will inspire others and give them hope in the face of a cancer diagnosis.

Health awareness

Measles: signs and symptoms

Learn more about what the measles virus is and how measles spreads

September 17, 2025

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Illustration of a person holding a child. A circular inset on the left side of the image contains various virus-like particles, indicating an infection or illness.

What is measles?

Measles is a highly contagious viral disease that can affect people of all ages but is most common in children. The virus lives in the mucus of the nose and throat of an infected person.

Measles spreads through the air when an infected person coughs or sneezes. Symptoms appear 7 to 14 days after contact with the virus.

Common measles symptoms include:

High fever

(may spike to more than 104°F)

Cough

Runny nose

Red watery eyes

(7-14 days after contact with the virus)

Tiny white spots in mouth

(2-3 days after symptoms begin)

Rash

(3-5 days after symptoms begin)

How measles spreads

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Is measles airborne?

The measles virus can live for up to two hours in an airspace after an infected person leaves an area.

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How contagious is measles?

If one person has measles, up to 90% of unvaccinated people close to that person will also become infected.

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How long is measles contagious for?

Infected people can spread measles to others four days before through four days after the rash appears.

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How long is the measles incubation period?

After being exposed to the measles virus, it can incubate for up to 21 days. An incubation period is how long it takes for you to develop symptoms after exposure to an infectious disease.

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Does measles cause complications?

Measles can cause health complications. Common complications include ear infections and diarrhea. Serious complications include pneumonia and encephalitis (an inflammation of the brain). Measles may impact the daily lives of patients and their caretakers (e.g., can result in lost work time or missed school days).

Measles can be serious and lead to complications 

  • About 1 in 5 unvaccinated people in the U.S. who get measles are hospitalized.
  • As many as 1 out of every 20 children with measles get pneumonia, the most common cause of death from measles in young children.
  • Approximately 1 to 3 of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.

Understanding measles outbreaks

Before the vaccine became available in 1963, an estimated 3 to 4 million Americans contracted measles each year; an estimated 48,000 people in the U.S. were hospitalized and there were approximately 400 to 500 deaths annually.

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Endemic (regularly occurring within an area or community) measles was declared eliminated in the U.S. in 2000.

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2025 saw the greatest number of measles cases reported in the U.S. since 1992.

When you’re contagious with measles, up to 90% of the people around you who are not vaccinated will also become infected.

In the U.S., measles cases can originate from international travel as the disease remains common in many parts of the world. Typically, 2 out of 3 of travelers with measles are unvaccinated Americans re-entering the country.

As seen by the recent outbreaks across the country, measles can spread rapidly, and infected individuals can spread measles to other people who are not immune.

Health awareness

Helping protect against vaccine-preventable diseases

Vaccination is one of the many ways you can help protect your loved ones against certain vaccine-preventable diseases

September 10, 2025

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Vaccines are one of the greatest public health success stories in history

Vaccines help protect against more than 30 potentially life-threatening diseases and are one of the greatest public health achievements of our time.

We recognize and support many global health stakeholders for their efforts in raising awareness about the importance of vaccination and helping prevent infectious diseases around the world.

Broader vaccination coverage along with other public health measures have contributed to the eradication of smallpox and significantly decreased the incidence of other vaccine-preventable diseases.

Declining immunization rates persist

Childhood immunization rates have been declining in recent years, with the global population facing the largest sustained decline in approximately 30 years.

mother laying down in bed with her newborn

A downward trend in global immunization persists, with immunization coverage stalling in 2023, leaving 2.7 million more children un- or under-vaccinated compared to 2019.

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Research shows that routine childhood vaccinations for people in the U.S. born from 1994-2023 have contributed to helping prevent about 508 million illnesses and 32 million hospitalizations.

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In 2024, it’s estimated that more than 14.3 million infants around the world did not receive some routinely recommended vaccines.

Recovering immunization rates together

Now, more than ever, we have an opportunity to reimagine the role we all can play.

At Merck, our broad portfolio of vaccines helps protect against certain infectious diseases affecting individuals around the world and across all stages of life from infancy through older adulthood. Through our work in vaccines, we’re committed to helping protect people from vaccine-preventable diseases today and for generations to come.

But we can’t be successful alone. That’s why we’re working with a variety of stakeholders to help increase vaccination rates, build trust and enable access to vaccination services for everyone who can benefit from them.

We’re also encouraging individuals to speak with their health care providers about vaccines that may be recommended for them or their families.

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Merck and its legacy companies have a 100+ year history of innovation and commitment to helping prevent disease by discovering, developing, supplying and delivering vaccines.

To keep pace with the ever-evolving disease landscape, we go where the need is to find new ways to address complex public health problems. We continue to invest in groundbreaking research and breakthrough technologies to help protect against potentially life-altering vaccine-preventable diseases.

Health awareness

Is your child up to date on their vaccines? Make a plan today

Keeping kids’ vaccinations current can help protect them against vaccine-preventable diseases

August 18, 2025

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One of the many ways parents can help protect their kids from certain infectious diseases is by keeping them up to date on their recommended vaccines.

“Vaccines are powerful tools that can help protect against certain diseases. Making sure your kids are up to date on their vaccines is one way you can help protect them,” said Andrew “Drew” Otoo, PharmD, president of global vaccines from 2022-2025 and current regional president, Merck. “Speak with your child’s health care provider and ask about vaccines that may be recommended.”

In addition to scheduling vaccinations, child well-visits are essential for discussing concerns about children’s health and tracking growth and developmental milestones.

Dr. Andrew Otoo
Dr. Andrew “Drew” Otoo

“For all of us, let’s get creative. We’ve seen what our communities can do when it comes to new and effective ways to reach populations for vaccination.”

Even small actions can have an impact. Parents and community members can make a point to talk about routine and recommended vaccinations. Health care providers can use electronic health records and immunization registries to remind parents to schedule well-child visits for children who may be overdue for a check-up.

It’s critical to improve and maintain high vaccination rates

In 2023:

~21M

~21 million children around the world were either unvaccinated or undervaccinated in 2023. 14.5 million children did not receive any vaccines, almost 2 million more than in 2019, according to UNICEF.

40%

40% of adults in the U.S. feel it is “extremely important” for parents to have their children vaccinated, down from 58% in 2019 and 64% in 2001. (Gallup, July 1-21, 2024).

Persisting challenges around vaccination equity and confidence can lead to drops in vaccination coverage rates, putting children and individuals of all ages at risk of potentially serious, yet vaccine-preventable, diseases.

“Our purpose is clear: How can we continue to increase vaccination rates for all recommended vaccines for all populations, including underserved communities, to help protect public health? There is an urgency to this work,” said Otoo.

Health literacy is also key in these efforts. When you understand health information, you can make make informed health decisions.

“We’re surrounded by so much information coming at us from so many directions, and it can be hard to make sense of where to go for guidance or answers,” said Otoo. “It’s so important to make sure that we’re providing information that parents can understand to help them make informed decisions about vaccination for their families, as well as overall health care.”

For more than 100 years, Merck has been a pioneer in the fight against vaccine-preventable diseases. But the burden is still too high, and new threats to global health will emerge. That’s why we are continuing to invest in groundbreaking research and breakthrough technologies to help protect against a variety of potentially serious infectious diseases. We’re also collaborating globally, nationally and locally to build trust, enable access and improve vaccination rates.

We remain focused on helping to protect people around the world and across all stages of life.

Health awareness

Navigating RSV disease: one family’s journey

As the leading cause of hospitalization for infants in the U.S., respiratory syncytial virus (RSV) can progress to severe illness for some babies

June 11, 2025

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Mom holding Charlotte

Caring for a child with respiratory syncytial virus (RSV) can be challenging. New parents Amanda and Jeremy thought they were as prepared as possible for any illness for their daughter Charlotte.

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Charlotte’s first night in the pediatric ICU.

They had an established pediatrician, supportive family and friends and a variety of resources and supplies on hand to help manage symptoms. But they weren’t prepared for Charlotte to progress from having what they initially thought was a cold, with a cough and runny nose, to being admitted to the pediatric intensive care unit for RSV at only 7 months old.

RSV is a contagious, widespread seasonal infection and the leading cause of hospitalization for infants under a year old in the U.S. Infants are among the populations most at risk of contracting the severe virus during their first RSV season, which typically starts in the fall and peaks in the winter in most regions of the U.S.

Charlotte’s experience with RSV

“Charlotte was a happy, chill baby. When she wasn’t happy, it was usually a sign that she was about to get sick,” said Amanda, who as a first-time parent hadn’t thought much about RSV up until that point.

On the day Charlotte was cleared to go home.

As Charlotte’s symptoms worsened, their doctor told Amanda and Jeremy what to look out for, mainly retracting or pulling in between and under the ribs, which was a sign of her struggling to breathe.

Amanda and Jeremy were surprised when Charlotte was admitted for difficulty breathing due to RSV and stayed in the pediatric ICU for a week.

Fortunately, she recovered and Amanda and Jeremy were so appreciative of her medical care. Today, Charlotte is a healthy and happy 3-year-old who loves spending time with her parents and younger brother.

Amanda understands that her family’s experience is unfortunately not unique.

"I urge all parents to understand the signs and symptoms of RSV so you can be prepared."

— Amanda

The impact of RSV on infants

RSV is a common seasonal respiratory infection that can be spread through virus droplets when an infected person coughs or sneezes, or through direct contact with the virus, like kissing the face of a child with RSV.

It’s the most common cause of hospitalization in infants under one year old in the U.S.

Common symptoms include a runny nose, fever, coughing and wheezing. While RSV doesn’t usually cause severe illness, healthy and at-risk infants can develop more severe cases that may lead to illnesses such as bronchiolitis (inflammation in the small airways of the lungs) or pneumonia (infection of the lungs) and may require hospitalization.

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It’s important for caregivers to speak with a health care provider to learn more about RSV and its symptoms.

Health awareness

Infectious disease detection and prevention

Learn more about how to detect and help prevent many infectious diseases

June 2, 2025

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Infectious diseases are illnesses caused by pathogenic microorganisms such as bacteria, viruses, fungi and parasites that can spread directly or indirectly from one person to another. These diseases can range from mild to severe and can affect various bodily systems, potentially leading to significant health complications and, in some cases, death.

Vaccination is one way we can help protect against certain infectious diseases. However, in recent years, vaccination rates have been declining, which has contributed to outbreaks of some infectious diseases. For example, measles was declared eliminated; yet in 2019, there was a large measles outbreak in the U.S. with 1,274 cases reported across 31 states, which was the greatest number of cases reported in the country since 1992. And as recently as 2025, outbreaks continue to appear in parts of the U.S.

Outbreaks like these are a worrying sign of a heightened risk for the spread of vaccine-preventable diseases.

Information about certain infectious diseases 


Hepatitis A    |    Hepatitis B     |     Measles     |     Mumps   I    Rotavirus   I    I Rubella

Hepatitis A

Hepatitis A is a disease of the liver caused by the hepatitis A virus, which spreads when someone ingests the virus, usually through person-to-person contact or by consuming contaminated food or drink. Those infected may feel sick for a few weeks or several months.

Signs and symptoms of hepatitis A

  • Dark urine or clay-colored stools
  • Feeling tired
  • Diarrhea
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea
  • Yellow skin or eyes (jaundice)

Potential risks and complications

In rare cases, hepatitis A can cause liver failure and death.

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Hepatitis B

Hepatitis B is a disease of the liver that’s transmitted when blood, semen or another body fluid from a person infected with the hepatitis B virus enters the body of someone who is uninfected (e.g., during sexual contact or childbirth). The disease can range from a mild, acute illness lasting a few weeks to a serious long-term, chronic infection.

Illustration of young girl

Signs and symptoms of hepatitis B

  • Dark urine or clay-colored stools
  • Feeling tired
  • Fever
  • Joint pain
  • Nausea, stomach pain or vomiting
  • Yellow skin or eyes (jaundice)

Potential risks and complications

Approximately 15%-25% of people with chronic infection develop chronic liver disease, including cirrhosis, liver failure or liver cancer.

About 9 in 10 infants infected with hepatitis B ultimately develop a chronic infection, with the risk of chronic infection decreasing as the child gets older.

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Measles

Measles is highly contagious and can cause serious health complications, especially in children younger than 5 years old. The disease spreads through the air when an infected person coughs or sneezes, with symptoms appearing seven to 14 days after contact with the virus.

By 2000, due to effective use of vaccines along with collaborative efforts with public health organizations and health care professionals, measles was declared eliminated from the U.S. However, outbreaks continue to occur.

Learn more about measles.

Illustration of small boy with red spots on his arm

Signs and symptoms of measles

  • Fever
  • Cough
  • Runny nose
  • Red, watery eyes
  • Spots in mouth
  • Rash

Potential risks and complications

Complications from measles include ear infections in about 1 in 10 children and diarrhea in fewer than 1 in 10 cases. Some children may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (infection of the brain).

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Mumps

Mumps is caused by a virus that affects the salivary glands. The disease spreads through direct contact with saliva or respiratory droplets from the mouth, nose or throat. It can take two to four weeks for signs of infection to show.

At one time, mumps was the most common cause of acquired deafness in the U.S.

Illustration of boy

Signs and symptoms of mumps

  • Puffy cheeks and a tender, swollen jaw
  • Fever
  • Headache
  • Muscle aches
  • Tiredness
  • Loss of appetite

Potential risks and complications

Although rare, mumps can cause serious complications, which include inflammation of the testicles (a condition known as orchitis).

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Rotavirus

Rotavirus commonly spreads in families, hospitals and child care centers with symptoms usually starting about two days after a person is exposed to the virus. Some symptoms can last three to eight days.

Illustration of baby

Signs and symptoms of rotavirus

  • Severe watery diarrhea
  • Vomiting
  • Fever
  • Stomach pain
  • Dehydration
  • Loss of appetite

Potential risks and complications

Although usually self-limiting, severe illness can result in dehydration with shock leading to hospitalization or, on rare occasions, even death

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Rubella

Rubella, also known as German measles, spreads when an infected person coughs or sneezes. The disease is usually mild with few noticeable symptoms.

About 25 to 50% of people infected with rubella will not experience symptoms but will still be at risk of spreading the infection to others.

Illustration of girl

Signs and symptoms of rubella

  • Fever
  • Headache
  • Mild pink eye (redness or swelling of the white of the eye)
  • General discomfort
  • Swollen and enlarged lymph nodes
  • Cough
  • Runny nose

Potential risks and complications

Rubella is especially dangerous to developing babies during pregnancy. If you’re pregnant and become infected with rubella, there’s an increased risk of having a miscarriage or the baby dying just after birth. The virus can also be passed on to the baby, who may develop congenital rubella syndrome, which includes birth defects such as heart problems, hearing and/or vision problems or developmental delays.

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Understanding disease prevention 

Illustration of doctor and patients

It’s important to learn about the potential risks of these diseases.

Talk to your health care provider about ways to help prevent infectious diseases including appropriate vaccines for you and your family.

Band aid applied to arm

Vaccines: Our history, our legacy

We’ve spent more than a century working to discover and develop vaccines.

Health awareness

Addressing the global shortage of TICE BCG

A new facility will triple our manufacturing capacity and address anticipated global demand for TICE BCG for the foreseeable future

May 30, 2025

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Since 2012, when Merck became the sole manufacturer of TICE® BCG BCG LIVE (for intravesical use) in many locations around the world, increasing global demand has outpaced our current maximum manufacturing capabilities. Committed to producing TICE BCG, in 2021 we announced our plans to construct a new manufacturing facility to significantly expand our production capacity for TICE BCG.

Once fully operational, the new facility will triple our current manufacturing capacity, with supply gradually increasing over time, and address global demand for TICE BCG. We’re investing more than $650 million in the new manufacturing facility, which is expected to be fully operational by late 2026 following inspection, regulatory review and approval.

Warehouse used to maintain inventory of materials used for TICE BCG production

This medicine has a lengthy and complex manufacturing process. Each batch takes more than three months to make, 30 days of which are spent waiting for the growth of a bacteria used to make the medicine.

This investment reaffirms Merck’s longstanding commitment to producing this medicine, and all our medicines, for patients who need them. We recognize the impact supply shortages can have on patients when they can’t receive the medicines they need. Until the new facility is complete, we’ll continue to use a system to proportionally allocate TICE BCG to minimize disruption to patient care as much as possible.

If patients have questions regarding TICE BCG, they should speak with their physicians. Additional information related to the shortage, current allocation practices and our efforts to increase supply, including construction of a new manufacturing site, is below.

What caused the TICE BCG shortages and backorders?

Since 2012, when Merck became the sole manufacturer of TICE® BCG BCG LIVE (for intravesical use) in many locations around the world, increasing global demand has outpaced our current maximum manufacturing capabilities. While we have many years of experience producing TICE BCG, this medicine has a lengthy and inherently complex manufacturing process.

Prior to 2012, additional manufacturers supplied the U.S. market with TICE  BCG, with Merck providing 30-40% of the U.S. supply. As other manufacturers exited the U.S. market in 2012, Merck increased production of TICE BCG to the full extent allowed by our current manufacturing capacity, which effectively doubled our supply of TICE BCG to the U.S. market.


What’s the latest update on the new TICE BCG facility?

Merck is investing more than $650 million to construct a new manufacturing facility to significantly expand production capacity for TICE BCG (first announced in 2021). We expect the facility to be fully operational by late 2026, following inspection, regulatory review and approval, and will address the anticipated demand for TICE BCG.

Once operational, our manufacturing capacity of TICE BCG will triple, and we expect supply to gradually increase over time following local market review and approvals.


How does the TICE BCG allocation process work?

To minimize disruption to patient care as much as possible until the new facility is complete, we’ll continue to use a system to proportionally allocate TICE BCG based on historical demand or in accordance with existing contractual obligations.

Merck allocates available supply among its network of wholesalers and distributors based on historical purchasing patterns or in accordance with existing contractual obligations. In turn, wholesalers and distributors allocate their inventory of TICE BCG to their own customers. End customers, including hospitals or private physician practices, cannot order product directly from Merck. This process is designed to proportionally allocate TICE BCG to minimize disruption to patient care as much as possible.


Where can I find more information about the availability of TICE BCG?

Patients:
Patients should reach out to their physician, as they are in the best position to answer questions about the availability of the medicine in their practice and can inquire about the quantity and timing of product availability with their supplier.

Health care professionals:
Health care professionals with questions regarding allocation should contact their wholesaler or distributor.

 


Health awareness

Endometrial cancer: Understanding the signs and symptoms

Learn more about how you can detect endometrial cancer

May 13, 2025

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As we age, certain changes can seem like a part of getting older, such as periods that are lighter or heavier than normal, or spotting between cycles. Yet it’s important that we recognize and raise these changes with health care providers because they may signal a more serious issue, such as endometrial cancer.

What is endometrial cancer?

Endometrial cancer is the second most commonly diagnosed gynecologic cancer worldwide. It occurs when cancerous cells form in the tissues of the endometrium or inner lining of the uterus.

How can I learn if I’m at risk for endometrial cancer?

The average age of diagnosis is around 60, with most cases occurring after menopause. Studies show Black women are more likely to be diagnosed with endometrial cancer than white women.

While age, race, family history and lifestyle choices all impact the risk of endometrial cancer, conditions that affect the body’s estrogen levels can also play a role. For example:

  • Estrogen-only hormone replacement therapy for menopause often includes an increase of unopposed estrogen to manage menopausal symptoms.
  • Polycystic ovarian syndrome (PCOS) usually creates higher estrogen levels.
  • Estrogen modulators may cause the uterine lining to grow.
  • Certain comorbidities, including obesity, type 2 diabetes and hypertension, have been linked as risk factors for endometrial cancer. For example, in people with obesity, fat tissue can convert certain hormones into estrogen, which increase the levels in the body.
  • The number of menstrual periods in a lifetime and a history of no pregnancies can affect estrogen levels. Beginning menstruation at a young age and experiencing menopause at a late age increases exposure to estrogen.

Abnormal vaginal bleeding is the most common sign of endometrial cancer, but there are others to keep in mind.

lady-and-physician-talking

What to watch out for:

  • Bleeding after menopause
  • Bleeding between periods
  • A change in periods
  • Vaginal spotting
  • Abnormal vaginal discharge
  • Pelvic pain or discomfort
  • Changes to bowel or bladder habits

How is endometrial cancer diagnosed?

As there is no routine screening exam to diagnose endometrial cancer before symptoms begin, it’s important to report signs or symptoms to your doctor right away. For those who have gone through menopause, it’s especially important to report any vaginal bleeding, spotting or abnormal discharge.

Tests to diagnose endometrial cancer may include:

  • Endometrial biopsy: A thin, flexible tube is inserted into the uterus to collect a tissue sample from the endometrium.
  • Dilation and curettage: The cervix is dilated to collect tissue from the inner lining of the uterus.
  • Hysteroscopy: An instrument with a light and lens for viewing is inserted into the uterus to look for abnormal areas.
  • Transvaginal ultrasound: A probe is inserted into the vagina to produce images that are used to assess the pelvic organs, including the uterus.

physician and lady talking

Being diagnosed with endometrial cancer can be scary. But by speaking with your doctor, you can better understand your options and build the best path forward.

Health awareness

When cancer comes back

An oncology researcher explains who's at higher risk for cancer recurrence and what you can do to make it less likely

May 13, 2025

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After completing cancer treatment, patients may experience both feelings of joy and relief as well as the fear of cancer returning.

“The thought of cancer coming back can bring on a lot of emotions, but not all recurrences are the same and not all will require active treatment,” said Dr. Marjorie Green, Merck’s senior vice president and head of oncology global clinical development. “It’s important to be aware of the possibility and talk with your doctor to understand your risk.”

What is cancer recurrence?

Cancer recurrence is the return of a previously diagnosed cancer after a period during which it was undetectable. Recurrence can happen weeks, months or even years after the initial diagnosis and treatment. The cancer might come back in the same place it first started, or it might come back somewhere else in the body. The different types of recurrences are:

  • Local: Cancer returns at the same place it first started.
  • Regional: Cancer is detected in lymph nodes near the place it first started.
  • Distant: Cancer comes back in another part of the body.

Who’s at risk for cancer recurrence?

While any cancer can come back, certain types are more likely to return, for example, cancers of the bladder and pancreas. Triple-negative breast cancer (TNBC), which is hormone-receptor negative, is more likely to recur than hormone-receptor positive breast cancer. Cancers caused by tobacco use also have a higher risk of recurrence.

Beyond cancer type, certain other factors can also influence the likelihood of recurrence, including stage at diagnosis (advanced or metastatic stages may have a higher chance of returning) and tumor growth rate.

Reducing the risk of recurrence

Dr. Marjorie Green

“Because patients who’ve been treated for cancer face a risk of recurrence, staying informed and proactive is essential.”

  • Dr. Marjorie Green

In addition to eating right and exercising, it’s also important to stay on top of follow-up visits with your health care team. A helpful question to ask during appointments may be: Could cancer spread or come back after surgery?

“Surgery is not always the end of cancer treatment because even if all visible cancer is removed, there still may be some tumor cells remaining in the body that are too few to be detectable on screening or diagnostic tests,” Green said.

Screenings to detect new cancers are important for survivors who might be at higher risk of developing another cancer because of their treatments or from increasing age. Screenings also may help catch potential recurrences at an earlier, more treatable stage.

Learn more about the importance of diagnosing cancer early.

Health awareness

Supporting colleagues working with cancer

There are so many unknowns after a cancer diagnosis — whether or not you receive support at work shouldn’t be one of them

April 17, 2025

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Chet Kitchen in hospital bed

Chet Kitchen had no idea how his battle with cancer would affect his work. Our colleague of 25 years and director of global regulatory policy wasn’t used to missing big meetings and presentations for hospital visits and oncology appointments.

“It’s a constant balance between trying to focus on work and trying to focus on your health,” said Kitchen. “That’s where having a good company to support you and colleagues who appreciate you and look out for you can make the difference.”

Kitchen is a head and neck cancer survivor. After following his doctor’s treatment plan for stage 4 squamous cell carcinoma of the tonsil, he was told there was no evidence of disease. But a year later, the cancer returned, and he was put on a new treatment plan.

Head and neck cancer can begin in or around the throat, voice box, sinuses, mouth and salivary glands. More than 90% of head and neck cases are squamous cell carcinoma, which is cancer that starts in the cells that line the mucosal surfaces of the head and neck. Symptoms may include a lump in the neck or sore in the mouth or throat that does not heal or may be painful, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice. 

Impact of cancer on careers

“One of the most important things a company can do to support a colleague living with cancer is to listen and understand their needs,” Kitchen said.

“To have the opportunity to take time off was so important,” he said. “My company gave me the flexibility to take care of my emotional needs by allowing me to focus on my health when I needed to, but also to focus on work when I didn’t want to think about cancer.”

Ongoing employment and return to work may help promote a sense of normalcy and control for cancer patients.

“Being diagnosed with cancer may hurt your career or make it more challenging,” Kitchen said.

“But working for our company really invigorated me. I can really appreciate the work that we do and how it impacts patients.”

— Chet Kitchen

Why we support the Working with Cancer pledge

At Merck, we’re dedicated to supporting people living and working with cancer around the world. We’re proud to be an accredited CEO Cancer Gold Standard employer and a founding member of the Working with Cancer pledge to help provide a more open, supportive and recovery-forward culture at work for cancer patients like Kitchen.

Chet Kitchen

Today, Kitchen’s cancer is in remission, but that doesn’t mean his patient journey is over.

“Even though you’re not physically battling cancer, it never really leaves you because it’s always somewhere in your mind,” he said. “But one of the things that’s really helped me emotionally through my survivorship is sharing my story.”