Gastric Cancer Specialist in Guatemala
Gastric cancer requires specific training in digestive tumors.
Treatment for stomach and esophageal cancer depends on the tumor's characteristics. Knowing them from the start makes it possible to use the best treatments available — including options many patients never receive because they weren't tested for in time.
When should you consult Dr. Reynoso?
You were diagnosed with stomach or esophageal cancer and need a complete oncologic evaluation
Your diagnosis doesn't include HER2, PD-L1, or MSI testing
You have difficulty swallowing, weight loss, or persistent abdominal pain
Endoscopy showed a suspicious lesion and you need guidance
Your current treatment isn't working and you're looking for options
You want a second opinion before starting perioperative chemotherapy
⚡ Consultations Monday, Tuesday, and Thursday | By appointment only
15-20%
of gastric adenocarcinomas are HER2-positive — eligible for anti-HER2 therapy
UAM
specific training in digestive tumors — Universidad Autónoma de Madrid
8+
years treating gastric and esophageal cancer in Guatemala
Q600
initial consultation with molecular review and treatment plan
HER2, PD-L1, MSI. Three markers that change the treatment.
Gastric and gastroesophageal junction adenocarcinoma are classified based on molecular profile — HER2, PD-L1 expression, and MSI/MMR status. Each profile has distinct treatment options that significantly improve outcomes when identified from diagnosis.
A HER2-positive gastric tumor treated with trastuzumab plus chemotherapy has a longer median survival than a tumor without that therapy. An MSI-high tumor responds extraordinarily well to pembrolizumab. A tumor with CPS ≥5 has access to first-line immunotherapy. Without molecular testing, those options don't exist for the patient.
“Gastric cancer is one of the diagnoses where the molecular profile changes the treatment the most. HER2, PD-L1, MSI — these are three tests that should be done from diagnosis, not after the first line of treatment.”—Dr. Giovanni Reynoso
Symptoms that shouldn't be ignored.
Gastric cancer is often diagnosed at advanced stages because early symptoms are nonspecific. Endoscopic evaluation is essential when symptoms persist.
Dysphagia
Difficulty swallowing — first solids, then liquids. A cardinal symptom of esophageal and gastroesophageal junction adenocarcinoma.
Unexplained weight loss
Weight loss without a change in diet. A common and often early systemic symptom in gastric cancer — frequently the first to appear.
Persistent epigastric pain
Pain or discomfort in the upper abdomen that doesn't improve with antacids or that progressively worsens. Different from typical reflux burning.
Early satiety
Feeling full after eating small amounts of food. May indicate a gastric tumor reducing the stomach's capacity.
Persistent nausea and vomiting
Frequent vomiting with no obvious cause, especially if it contains blood or coffee-ground-like material.
Anemia with no obvious cause
Iron-deficiency anemia in an adult with no evident bleeding. May be the first sign of a gastric cancer with occult bleeding.
Hematemesis or melena
Vomiting blood or black stools. In the right context, may indicate a bleeding gastric tumor requiring urgent evaluation.
Do you identify with any of these?
A first one-hour consultation is enough to begin your workup and, if applicable, reach a clear diagnosis
Gastric cancer progressed. And key information may be missing.
Progression in metastatic gastric cancer is common after the first line of treatment. But in many cases, progression happens in patients who never had a complete molecular profile — and who could have access to anti-HER2 therapy or immunotherapy that was never considered.
Gastric tumor without HER2 testing
A HER2-positive gastric adenocarcinoma treated only with standard chemotherapy, without trastuzumab, has significantly worse outcomes than one treated with the correct protocol. If HER2 wasn't tested at diagnosis, it can be tested on available tissue — and change the strategy even in the second line.
MSI-high gastric tumor without immunotherapy
MSI-high tumors have extraordinary responses to pembrolizumab — even in the second or third line. Without MSI testing, that option doesn't exist for the patient. Dr. Reynoso identifies these patients and treats them with the correct protocol.
Progression after first-line treatment with available options
Trastuzumab deruxtecan for previously treated HER2-positive cases, ramucirumab with or without paclitaxel, nivolumab as second-line therapy — there are second-line options with demonstrated benefit in advanced gastric cancer that aren't always considered.
“Gastric cancer is one of the diagnoses where the molecular profile changes the treatment the most — even in the second line. Before saying there are no more options, I need to know whether HER2 and MSI were tested.”—Dr. Giovanni Reynoso
How gastric cancer is evaluated in consultation
A complete oncologic diagnosis of gastric cancer requires histology, molecular profile, staging, and resectability assessment. The first consultation with Dr. Reynoso reviews what's already complete and what's missing.
Complete case review
Detailed medical history, review of endoscopy, biopsy result, imaging studies, and prior treatments.
Complete molecular profile
HER2 by immunohistochemistry and FISH when applicable, PD-L1 expression (CPS), and MSI/MMR status. If not yet performed, they're requested on available biopsy tissue.
Staging
Contrast-enhanced CT of chest, abdomen, and pelvis. PET-CT when indicated. Diagnostic laparoscopy to rule out peritoneal carcinomatosis in locally advanced tumors before surgery.
Resectability assessment
In localized disease, a multidisciplinary evaluation with surgical oncology determines whether the tumor is resectable with curative intent and whether it requires perioperative chemotherapy before surgery.
Systemic protocol design
Perioperative chemotherapy (FLOT for resectable disease), anti-HER2 therapy with trastuzumab for HER2-positive cases, immunotherapy with nivolumab or pembrolizumab for CPS ≥5 or MSI-high cases.
Coordination with surgery and nutrition
Managing gastric cancer requires close coordination with surgical oncology and nutritional support — especially in patients with significant dysphagia or weight loss before treatment.
Why consult Dr. Reynoso for gastric cancer?
Specific training in digestive tumors — UAM Madrid
Dr. Reynoso completed specific training in digestive tumors at the Universidad Autónoma de Madrid — a subspecialization that translates directly into the clinical depth he brings to gastric and esophageal adenocarcinoma.
Complete molecular profile from diagnosis
HER2, PD-L1, and MSI are requested from the diagnostic biopsy — not after the first line of chemotherapy. Identifying these markers from the start allows the best available agents to be used from the beginning.
Immunotherapy available for select profiles
Pembrolizumab and nivolumab are indicated for metastatic gastric cancer based on molecular profile — CPS ≥5, MSI-high. Dr. Reynoso identifies eligible patients and treats them with the correct protocol.
Coordination with surgery and nutritional support
Gastric cancer frequently affects the patient's nutrition. Dr. Reynoso coordinates systemic treatment with surgical management and nutritional support so the patient arrives at treatment in the best possible condition.
Specific training in digestive tumors — UAM Madrid
Dr. Reynoso completed specific training in digestive tumors at the Universidad Autónoma de Madrid — a subspecialization that translates directly into the clinical depth he brings to gastric and esophageal adenocarcinoma.
Complete molecular profile from diagnosis
HER2, PD-L1, and MSI are requested from the diagnostic biopsy — not after the first line of chemotherapy. Identifying these markers from the start allows the best available agents to be used from the beginning.
Immunotherapy available for select profiles
Pembrolizumab and nivolumab are indicated for metastatic gastric cancer based on molecular profile — CPS ≥5, MSI-high. Dr. Reynoso identifies eligible patients and treats them with the correct protocol.
Coordination with surgery and nutritional support
Gastric cancer frequently affects the patient's nutrition. Dr. Reynoso coordinates systemic treatment with surgical management and nutritional support so the patient arrives at treatment in the best possible condition.
Received a cancer diagnosis? The next step is a consultation.
First visit, second opinion, or oncologic follow-up — you deserve an oncologist who explains everything.
Medical Oncology in Guatemala City
Dr. Giovanni Reynoso - Oncólogo
Edificio Spazio, 15 avenida y 5 calle 5-50, Vista Hermosa III, Zona 15. Nivel 10, Oficina 10-01Bonanova Health, private hospital specializing in cancer in Zona 15
Office Hours
Monday to Tuesday from 4:00 PM to 6:00 PM Thursday from 3:00 PM to 5:00 PM
Emergency Care
Dr. Reynoso does not handle emergencies. For oncologic emergencies, go to the nearest hospital.
Coverage Areas
Guatemala City
- • Zona 15, Vista Hermosa I, II, and III
- • Zona 10, 14, 16
- • Zona 9, 13
- • Carretera a El Salvador
Metropolitan Area
- • Mixco
- • Villa Nueva
- • Santa Catarina Pinula
- • San Cristóbal
Departmental Coverage
- • All departments of Guatemala
- • Patients traveling from other parts of the country
- • Zacapa, Chiquimula, Izabal, San Marcos, Petén
International Coverage
- • El Salvador
- • Belize
- • Honduras
- • Costa Rica
Common questions, clear answers
Still have questions? Let’s talk directly on WhatsApp for personalized answers.