Bowel cancer is the second most prevalent cancer in Australia with rectal cancer the most common subgroup, representing 5% of all cancer diagnoses in 2008 [1]. Rectal cancer also accounts for 4.6% of all cancer deaths in New South Wales [1]. All rectal cancer that is T3/4 or node positive on pre-operative assessment should be considered for pre-operative therapy, which has been shown to significantly improve local control compared to postoperative chemoradiation. [2]. Pre-operative chemoradiation is standard pre-operative treatment at the Northern Sydney Cancer Centre with approximately 40 patients/year receiving this treatment. Surgery is normally performed 6-8 weeks following chemoradiation.