Re: can you have stage IV Colon cancer and NOT be anemic?
I am sorry to hear about these symptoms in your husband. Not all colon cancers or polyps bleed and even if they do, they may not bleed all of the time. This is why the occult blood test is not necessarily a foolproof test for colon cancer but the colonscopy certainly is.
I believe that both colon cancer and ovarian cancer are genetically related so your husband may very well have a gene that predisposes him to colon cancer. Only genetic testing would tell for sure if this is the case and if it is, this alone is grounds to have a colonoscopy at an early age. Genetics aside however, I am sure that you realize that if he is having symptoms, he definitely needs to have the colonoscopy.
Keep in mind that if he does have a problem and it does turn out to be cancer, he may not necessarily be at stage IV. With colon cancer in the earlier stages, some people may have blatant symptoms and others won't. Sometimes anemia is the only way colon cancer is discovered and the blood in the stool may not even be visible so the person would have no way of knowing. All depends upon WHERE a tumor is located. Tumors located in the upper part of the colon can go a long time without being noticed because waste is liquid and can pass easily at this point and even if a tumor bleeds, the blood may be well mixed in with the stool and not visible except with an occult blood test. This is why some of these tumors are accidentally discovered when the person is tested for anemia. Other tumors located lower down may cause more obvious symptoms since by the time waste makes it down the colon, it has moisture taken out of it and is more solidly formed. However, not all tumours bleed a lot or even at all.
You say that your husband has ribbon like stool. If this is caused by an obstruction then it will probably be located in the lower third of his colon. This is where stool is formed. If this is the case, even a sigmoidoscopy would uncover the problem. A sig is like a colonoscopy but it looks only at the lower third of the colon. However, a colonoscopy is strongly warranted as I am sure you must be aware. The worst thing about these tests is the prep. The actual test is not really that bad. You are not sedated for the sigmoidoscopy but you are for the colonoscopy AND if what your husband has is a bleeding polyp (some can be very large), it can be removed right then and there. You may want to explain this to your husband.
Your husband may be skirting the issue because he is afraid of what they will find. He really needs to realize that ignoring the issue will not make it go away and eventually he will be faced with it regardless. He also needs to realize that by ignoring it he is hurting you as well as himself. Sometimes people come around when they realize that they are not the only ones to loose out in such a situation.
I think you are right to get involved and my hat is off to you for being courageous enough to face this, even if your husband is still in denial that he has a problem. He will come around eventually and by then, perhaps you will have saved his life.
All the best to you. Take care.