Colorectal cancer diagnosis catches 38-year-old Fargo resident by surprise

Billie Kitzman had been fatigued for months.

"I felt lethargic on a molecular level and was having weird left-side abdominal pain," explained the 38-year-old Fargoan. At the time, she didn't realize she was also losing weight and color in her face.

Kitzman attributed the pain and associated bleeding to her menstrual cycle, but this changed on Oct. 23, 2025.

Despite a poor night's sleep due to pain, Kitzman recalls powering through and going to work. She was at her desk when hit by a wave of nausea.

"I left my computer on because I expected to be back," explained Kitzman, who went to the walk-in at the Essentia Health-52nd Avenue Clinic. "I figured they would give me antibiotics and be like, 'Your gut is weird.'"

Instead, she was sent to the emergency department at Essentia Health-Fargo. Testing revealed Kitzman’s hemoglobin level was 4.8 grams per deciliter. Blood transfusions typically begin when levels drop to seven.

"You cannot get to such a low level unless you've been bleeding for an extended period," explained Dr. Zachary Ernst, a general surgeon at Essentia. "If this were to happen quickly, your body wouldn't tolerate it, but if it's a gradual thing, your body can find time to correct, as was the case with Billie."

Kitzman received five units of blood and underwent a computed tomography (CT) scan to determine the cause behind her low levels.

Rachel DeHoogh, a nurse practitioner in gastroenterology, was also consulted. DeHoogh was with Kitzman when the imaging results came through. They showed a large mass in Kitzman’s lower abdomen.

"Unfortunately, we are seeing more cases of younger patients with colon cancer. Billie was one of the youngest patients I've diagnosed," explained DeHoogh. "She really took it all in stride, though, and was more concerned about someone checking in on her dog, Millie."

Dr. Ernst performed a colonoscopy the next day. A biopsy of the tumor was sent to pathology, and the results confirmed what was suspected — cancer.

"I named my tumor 'Carla' after an old high school geometry teacher — they both made my guts feel about the same," joked Kitzman.

On Nov. 18, Dr. Ernst removed the mass, which measured three inches in diameter, along with several inches of Kitzman's sigmoid colon and a portion of her small intestine. The tumor had attached to her bladder and invaded surrounding tissue.

In early December, Kitzman received a port and began chemotherapy under the care of Essentia oncologist Dr. Bassim Kobrossy. She currently undergoes treatment every other Monday.

Additional testing in January identified two small lesions on her liver as metastatic colon cancer — what Kitzman calls "Carla's cronies."

She will continue chemotherapy before undergoing radiofrequency ablation (RFA) in April. RFA uses heat delivered through a probe to destroy the lesions, the equivalent of surgically removing that portion of the liver.

Despite everything, Kitzman remains upbeat.

"Even on the hard days, I feel really lucky and so much better," she said. "My abdominal pain is gone. Even just doubling the amount of blood in my body made me feel like a rock star."

Kitzman's providers also credit her resilience, attitude and support system.

"This has been such a new experience for me in every way, but I’ve never felt alone or scared. That’s because of the team at Essentia," she said. "They saved my life."

Kitzman's message to others, including her six older siblings, is simple.

“If something feels weird, don't ignore it,” she said. “Don't be like me and almost run out of blood. Your body will tell you what's up.”

Follow Kitzman's journey on her CaringBridge.

Colorectal cancer rising among younger adults

Kitzman's diagnosis comes at a time when colorectal, or colon, cancer is increasingly affecting younger adults. According to a recent study, colorectal cancer is now the leading cause of cancer death for U.S. adults under the age of 50.

While the exact cause of early-onset colorectal cancer isn’t fully understood, a sedentary lifestyle, obesity, smoking, heavy alcohol use, certain diets and other environmental factors have all been associated with the disease. Symptoms can include unexplained weight loss, persistent abdominal pain or cramping, fatigue related to anemia and changes in bowel habits such as diarrhea, constipation or blood in the stool.

For individuals at average risk, regular screenings are recommended beginning at age 45. Those with a family history of colon cancer, inflammatory bowel disease or other risk factors may need to begin earlier. Screening can detect colorectal cancer before symptoms begin — and in some cases prevent it entirely by removing precancerous polyps. When no polyps are found and there is no family history, colonoscopies are typically needed only once every 10 years.

To learn more about screening options or how to prepare for a colonoscopy, visit EssentiaHealth.org or schedule an appointment with your primary care provider.