Watch and Wait Management on Rectal Cancer Patients Using New Swift Local Therapy

Inclusion Criteria: * Patients with histologic diagnosis by proctoscopic biopsy of invasive rectal adenocarcinoma will be considered for entry in this study. * Patient in whom the diagnosis of invasive rectal cancer has been obtained by incisional biopsy (surgical or endoscopic biopsy) that the majority of the tumor has not been removed . * The tumor should be either palpable by clinical rectal exam or accessible via a rigid proctoscope, and its proximal border should be located no more than 15 cm from the anal verge. * Rectal cancer clinically stage as T2-T3 N1+ by MRI or endoscopic ultrasound. * Tumor of 5 cm or less length, non obstructive * Patient is not suitable for surgery nor chemotherapy due to medical conditions * Patient must consent to be in the study and consent form must be signed, witnessed and dated prior to registration . * Patients must be accessible geographically for follow up. * Adults older than 18 years of age Exclusion Criteria: * Patient with malignant rectal tumors other than adenocarcinoma, i.e, sarcoma, lymphoma, carcinoid, squamous cell, cloacogenic, etc. * Patient who demonstrate prior to randomization, evidence of free perforation, as manifested by free fluid in the abdomen. * Patient who are curable by standard of care with either surgery or eligible for the Morpheus study. * Patient who have received any previous therapy (radiation , chemotherapy) for rectal cancer. * Patient whose tumor is fixed by clinical examination to surrounding structures, precluding the possibility of adequate surgical resection even with pelvic exenteration. * Patient with a performance status of 3 or 4. * Patient with tumor involving the anal canal. * Patient who are pregnant at the time of randomization. * Patient with psychiatric or addictive disorders that would preclude obtaining informed consent. * Patient who have multiple primary tumors involving both the colon and rectum that would preclude them from being classified as having only rectal cancer.