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The Implementation Guide for Patient Facesheet Update2012 2 Oncology Specialists

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next we are going to hear updates in.medical oncology and I would like to.welcome our next speaker dr. Joshua.Suvari who is an assistant professor in.the Department of Medicine here at.Perlmutter Cancer Center great again my.name is Josh Suvari I'm one of the.medical oncologists and the thoracic.oncology group and it's a real pleasure.to be here.and thanks for inviting me to this talk.so before I get started if someone you.know with the show of raising hands uh.who's been diagnosed with the lung.cancer or knows somebody who has a lung.cancer in the room.okay so quite a bit of you here in the.room and who has been a patient here at.NYU.okay all right so what I hope to do.today is go over lots of information and.I really liked it to be as interactive.as possible so I'm actually going to.call on people just to get your opinions.not individual people but you know just.to see what your thoughts are so what.we'll talk about is lung cancer.screening briefly and dr. Michaud went.over this already but this is probably.one of the most important things you're.going to hear today and one of the most.important things you're going to take.back to your family and friends because.if we can a prevent this or detect it.early we're going to be in better shape.all next talk about how to treat lung.cancers and this is a really complex.sort of field right now but I want to.give everyone here a lot of hope we've.had a lot of new discoveries in the last.few years.and I want to run through some of those.with you I'll talk a little bit about.our portfolio here of clinical trials.and that's how we develop new drugs.testing new drugs to lead to new.treatments to allow people to live.longer and have better quality of life.and then lastly I'll end with a new area.or a new field of liquid biopsy of how.to better understand the heterogeneity.or how different cancer is in different.places of the body so lung cancer.screening and again we heard a little.bit about this already so again early.detection saves lives so here at my U we.pioneered the use of cat scans back in.the 1990s for the early detection of.lung cancer and then since 2000 our lung.cancer screening program here has been.part of a National Cancer Institute.funded screening detection research.network and we've had 1,700 people to.date have participated in our biomarker.screening program here and dr. Guyton.already discussed this that there was a.national lung cancer screen.trial here here in other institutions.that showed a 20% reduction in the lung.cancer mortality so what is this lung.cancer screen that we all talk about.what actually happens has anyone had.this so what did they do yeah so it's a.simple cat scan it's a low-dose.radiation cat scan where you have a.discussion with your Fesenko we did you.have a discussion with your physician.and then you get a cat scan that takes.about 25 to 30 minutes and then you.discuss the results with your physician.in the office and this intervention.alone has led to a 20% reduction in.mortality so who should be screened and.this is the really important slide here.for everybody with family members or.anybody who they know of anyone who's.aged 55 to 77 years old and some.guidelines even reach out to about 80.years old who is smoked within the last.15 years or currently smokes and who's.willing to quit right if somebody's not.willing to quit screening doesn't make.the most sense cost-effectively and.again they had to have about a 30-pack.year history so that could be 2 packs a.day for 15 years equal to 30 or one pack.a day for 30 years so any of your family.friends loved ones who fits within this.category please urge them to get a.screening cat scan of the chest and.again this is a simple procedure it's.actually pretty cheap the amount of rate.and it's all covered by everyone's.insurance the amount of radiation is low.right so but but still significant in.the sense that we want to make sure that.we're benefiting people so they fit into.these categories here so we have a lung.cancer screening program here doctor.Mashhad is the director of the program.it's one of the larger ones in New York.and this is sort of the plug for the.program and I don't know if you guys.know dr. chu chua dr. Joshua who would.you know if he was your doctor here and.you were diagnosed with a lung nodule he.would sit down with you and go over with.this in the clinic and I really want to.take away any of the sort of fear and.stigma this is a screening test just.like a colonoscopy as a screening test.or a pap smear as a screening test or a.mammogram as a screening test this is a.critical piece that you should discuss.with your primary care doctors your.pulmonologist.and anybody else who you come into.contact with in medical care so let's.move to treatment and this is sort of.the exciting area in medical oncology.especially in lung cancers so what are.some of the factors of why we decide to.treat somebody with lung cancer or why.you know what anyone anyone know about.any of these factors that we think of.when thinking about how to treat a lung.cancer I'll open it up to the crowd good.so we want to understand the cancer what.makes that cancer tick and we talked.about that as genetic mutations or.abnormalities so the lung cancer in.somebody who is 45 and never smoked.versus the lung cancer and somebody who.is 85 years old and smoked 40 packs.yours may be different right there may.be different genetics in those different.cancers any other any other factors that.you think about one or you can bring up.that we think about in treating lung.cancer so genetics is critically.important Christina I didn't ask you to.ask but it was a planted question go for.it good so stage is critical and we're.going to spend a little bit of time.talking about stage has anyone heard.that word before yes what does that mean.so everybody is right so sighs good so.that the key here is where did the.cancer start and where has the cancer.gone and that's critically important.because if we identify cancers early.hence the screening program if we.identify cancers early right if they're.located only in the lung area we can.then think about having a patient seen.by a surgeon to have the cancer simply.removed or surgically resected and the.cure rate the the cure rate in.surgically resecting an early stage lung.cancer is high it's about 75% so the.earlier we can identify these.abnormalities the better people do so.what is a stage 4 lung cancer.so we staged a stage 4 lung cancer again.is a cancer that starts in the lung and.learns how to spread to other parts of.the body and in someone who's diagnosed.at the stage 4 lung cancer really the.role for surgery is limited and we.really talk about systemic treatments or.treatments that are able to go all over.the body.now how about stage 2 and stage 3 those.are sort of in the middle anyone know.that someone had a stage 2 or stage 3.cancer stage 3 a so what was that.close the chest.so so so three stage three cancer stage.two cancers are cancers that start in.the lung and learn how to travel to.lymph nodes and lymph nodes or areas.that actually help fight infection and.dr. Michaud already talked a little bit.about how important it is to sample the.lymph nodes to better understand where.has the cancer gone in the body so.correct with the stage three cancer we.generally can treat with either.chemotherapy and radiation followed by.surgery or with surgery followed by.chemotherapy that's sort of a more dicey.field but the key thing that I want to.get across to everybody in the room.today is that if we identify these early.right we can do surgery alone and if you.identify them later we need to do.systemic treatments or treatments that.can go all over the body and not.everyone cancer or not all cancers are.not the same everybody sort of has a.different cancer whether it's the stage.or like you had mentioned whether it's.the genetics of the cancer and that's.critically important when we're thinking.about the treatment so we talked briefly.already about stage so stage one we said.is just identified in one area of the.lung and again that can be surgically.resected a stage three cancer like you.had mentioned already learned how to.spread to the lymph nodes generally in.the center part of the chest and the.stage four cancer is a cancer that.learns how to spread to other parts of.the body usually through the bloodstream.so this is the treatment paradigm for.Stage four lung cancer back in 2015 only.three short year or three and a half.short years ago if somebody was.diagnosed with the cancer that started.in the lungs and spread or learned how.to spread to another part of the body.the treatments were chemotherapy okay.and if the cancer progressed on this.chemotherapy the second option was.chemotherapy as well now can anyone.raise their hand and name other types of.treatments that we have available now in.2018 so here we have targeted treatments.and immunotherapy so what we've added in.the last few years and this is why this.field has has you know exploded recently.and you know why again why people are.living longer.lung cancer and living better with lung.cancer is that we now have different.treatment options for people who have.stage 4 lung cancer so we used to only.have chemotherapy and chemotherapy again.is a critically important part of our.material what it does is it kills cancer.cells but unfortunately can also kill.normal cells and hence some of the side.effects that we discuss with you when we.see in clinic where as targeted therapy.is really specific to the action the.actual target in the lung cancer so if.someone has a targetable alteration and.anyone know any of them in the room.EGFR alq.ALK b raf b raf and there's one other.one that has an fda-approved drug so t7.ID and it's a great point we'll come.back to that that's a mutation that can.happen after EGFR the less so KS is one.that we don't have a great pill for or a.great you know a targetable mechanism.for you but we are working on it.the other one is Ross one or ros1 and.the reason why those four genes or four.abnormalities in those in those genes.are so important is because if we.identify them then we can match the.patient to a targeted therapy and oral.therapy and I always tell my patients.who I see I want you to be on the best.possible therapy for you.what does that mean it means the one.that's going to let you live the longest.and have the least amount of side.effects so that you can have good.quality of life and and that's the goal.so we now as a standard of care are.looking for genetic abnormalities that.each and every one of the patients that.we see in our clinic so I know I spoke.to some of you in the room already but.it's so important that you talk to your.Doc's and say you know what are my.genetics or what are the genetic.abnormalities in my cancer so not all.cancers have specific abnormalities that.we can block but we should look for them.and everybody so we talk.so it's a great Gamma Knife is a type of.local treatment or radiation type.treatment not specific to any one cancer.so we talked about chemotherapy we.talked about targeted therapy targeted.therapy or pills and we'll talk briefly.about immunotherapy before that you had.a question yeah so I am primarily.talking about non-small cell we can.briefly talk about small cell as well.that's an important point so we talked.about tart we talked about chemotherapy.we talked about targeted therapy and the.last one is immunotherapies anyone know.how immunotherapy works good so you know.there's a theory that we're all.developing cancers in our body all the.time and it's nothing wrong with your.immune system your immune system is.working well it's that your cancer sort.of outsmarts your immune system right so.it prevents it from recognizing it so.what immunotherapy is and the Nobel.Prize was just awarded about two months.ago now we're a month and a half ago now.the concept that can we get your immune.system to rev up a little bit to start a.better understand and recognize the.cancer so immunotherapy actually does.not kill cancer cells this is something.that is you know important for people.who are going through immunotherapy it.doesn't work quickly like chemotherapy.does it takes time for it to allow the.immune system to rev up to then better.recognize and attack the cancer and.interestingly the side effects of.immunotherapy are not the same as.chemotherapy right it doesn't kill.normal cells so things like nausea.things like hair loss may not be seen.with immunotherapy as they're seen in.chemotherapy what are the side effects.of immunotherapy.so your immune system normally is not.trying to recognize an attack it's.normal self and that's why the cancer.sort of slide under the door in the.sense and they're not being recognized.by your immune system but sometimes when.we remove those sort of breaks on the.immune system and let the immune system.run wild to hopefully recognize and.attack the cancer sometimes it could.recognize an attack our own normal self.and it can cause things like rash it can.cause things like diarrhea it can cause.things like shortness of breath so it's.very important that you talk to your.doctors if you're having any new.symptoms while receiving any ones of.these any kinds of these therapies.immunotherapy so back in 2015 this was.what our treatment paradigm was for.somebody who I would see in the office.and this is where we are in 2018 it's a.lot more complex right it's a lot more.going on and again this is a testament.to all the science in the lab and all.the clinical trials that are being done.in our clinic space so here's a list of.all the fda-approved drugs for the.treatment of lung cancer and I apologize.if it's too small and you can't read it.but anyone recognize any of the names of.the drugs on this board raise your hand.if you received one of these drugs good.so we're doing more and more and again.you know if you look at this slide these.are the drugs that have been FDA.approved in the last four to five years.okay so in 2012 we didn't have you know.a lot of the targeted therapies we had.no immunotherapy approved so look how.far we've come and this is a point that.I always make with every single person.who I made in the clinic is there's a.lot of hope I want everyone in the room.to know that we're doing a lot to study.this disease we're learning about new.mechanisms we're learning about.resistance of mechanisms and we're.learning about you know what different.drugs we can offer to patients that will.particularly help that individual person.so what are some of the trials that.we're running here at NYU and this is.not an exhaustive list but just one of.the lists and I want to highlight one of.the trials run by my colleague dr..Elaine Cheung looking at immunotherapy.in the early sort of setting in patients.who have lung cancers that are stage one.to stage 3 so cancers that have not.progressed through the body or not.learned how to travel through the body.can we.use immunotherapy there and could you.know that benefit people to live longer.so we talked a little bit about.immunotherapy already but I just want to.make this a point that immunotherapy in.the last two-and-a-half years has become.the standard treatment for all people.with Stage four lung cancer and you made.a good point are we talking about just.non small cell lung cancer or are we.talking also about small cell lung.cancer does anyone know the difference.between those two good so one is more.aggressive which one is more aggressive.small cells a little more aggressive and.it's seen exclusively and people who.smoke and non-small-cell lung cancer so.these are different categories that.explain sort of the biology or how the.cells look under the microscope.non-small-cell lung cancer has multiple.different subtypes of cancer does anyone.know those what's the most common type.of non smalls.so adenocarcinoma is the most common and.the second most common one here in the.United States squamous cell cancer.exactly so even in small cell and in non.small cell the standard of care in the.first-line setting now includes.immunotherapy.okay so chemotherapy is still important.in the first line but it should include.immunotherapy for every single patient.so we're able to measure something now.on the cancer cell called PDL one or.program death ligand one and the way I.think about that as sort of a cloak that.sits on the cancer cell that disguises.the immune system from recognizing the.cancer cell so if you have a high level.of that cloak or disguise there's a high.likelihood that if you remove the cloak.or you remove the disguise the immune.system will then be able to recognize.and attack the cancer and we can.actually grade that so we grade the PDL.1 or the cloak or to disguise that's on.the cancer cell and if you have a high.level of disguise greater than 50% we.then recommend immunotherapy alone in.non small cell lung cancer and if you.have a low level of cloak or disguise a.PDL 1 expression less than 50% we're.recommending chemotherapy and.immunotherapy together and that actually.was done out of this institution here at.NYU Lena Gandhi published in the New.England Journal of Medicine back in June.2018 and that has now become the new.standard of care so again to reiterate.that point June 2018 new standard of.care so things are rapidly evolving in.this space so again moving back to this.immunotherapy clinical trial dr. Shawn's.trial we're trying to understand can we.move the immunotherapy from the later.stages from stage four to the earlier.stages patients who have early stage.lung cancer stage one two and three and.would that allow people to live longer.so in people who have lung cancer that.is in the lung and they're an operable.candidate meaning they can go to the.operating room at some point this study.was done in a pilot in 22 people and.this is our sort of New England Journal.of Medicine is our New York Times right.this is the sort of premier journal that.we look at and neoadjuvant just simply.in English means to get immunotherapy or.to get a treatment before surgery.neoadjuvant pd-1 which we talked about.in this study they used a drug called.nuvola map which some of you may have.heard in patients who have resectable.lung cancers and this is just showing.one patient right who received two doses.of immunotherapy before the surgery.interestingly before the surgery here's.the tumor on the scan and four weeks.later that this study people received.two doses and it was every two weeks two.doses the tumor is sort of you know.almost gone and when we look at it.histologically this almost looks like a.normal specimen whereas this looks like.a cancer specimen so it's perhaps can we.study this in people moving forward can.we give a dose or two doses.immunotherapy before the operating room.and this is a study that is ongoing here.again led by dr. Sean where when we meet.a patient we we talked about the.standard treatments we offer them to see.a surgeon we offer chemotherapy which is.now standard of care and then we also.offer a clinical trial again clinical.trials are new opportunities to study.new things that may ultimately help.benefit that patient but also patients.in the future where we offer two doses.of this a tezo Lizza map which is.another.immunotherapy agent followed by surgery.and then we're able to tell in the.operating room whether the the.immunotherapy worked well in the patient.and if it did and if there's no evidence.of any cancer anymore in the surgery or.after the surgery we then offer the.immunotherapy after surgery.if the immunotherapy does not work which.a dozen in most people we then would.offer the standard types of treatments.so again this is a concept of us looking.at how can we move these drugs forward.to better help our patients that we're.seeing in clinic I want to just go over.two more clinical trials you had.mentioned the EGFR space and you had.talked about you know EGFR or epidermal.growth factor receptor is a commonly.mutated gene in folks who develop cancer.we see it in about 10% of the people.especially folks who were never smokers.and if we identify that abnormality were.able to match a patient to a targeted.therapy or a pill has anyone heard of.the pill or been on the pill what's the.name of the pill to Chris so excellent.so to Grist aware Aussie Merton is the.fda-approved first-line regimen of.first-line pill and there's a really.neat story here because that's not the.pill that was approved three years ago.that pill was only approved about a year.ago so what pill was approved three.years ago is a different type of pill so.Tarceva or erlotinib was approved three.or four years ago for this specific.cohort of patients and the reason why we.have a newer pill now is because we.learned more about the biology there was.great science done in the laboratory to.try to understand why people who.received Tarceva the initial pill that.was approved.why did their cancers continue to grow.over some time why did the pill or the.cancer become resistant to the pill and.that's where we identified the t79 zero.and that's a second resistance mechanism.so now to Griffo is better or we know is.better than Tarceva and people will all.receive two Grist oh in the first line.setting in someone who is diagnosed with.an EGFR driven cancer now even for two.Grist oh we do worry that resistance can.occur over time and when we do see.resistance we are now studying and.better understanding the knot.line of resistance and that's c79 7s or.something called met amplification and.we just secured a study that just opened.actually we put our first patient on at.this institution last week on Thursday.that is now looking to treat patients.who have progression of their cancer.after the AA Seibert number two Gris oh.you had a question up there yeah so t79.0m sounds like Greek right what does.that really mean it just means that EGFR.it's the location right it's like you.know first avenue second avenue third.Avenue the gene is sort of like the.block of or the the cityscape of.Manhattan and it's where the abnormality.happens does it happen on first day of.anyone second Avenue or third Avenue or.Lex and the abnormality t79 0m just so.happens to cause the cancer to become.resistant to the medication the Tarceva.and now we're finding other mutations.that happen on Lexington Avenue for.example right called the C 7 9 7 s and.if we're able to profile it or better.understand it right then we're able to.think about new mechanisms of resistance.and new mechanisms of blocking that.abnormality so that will lead me into.liquid biopsy which is critically.important and is a new a new sort of.technology in the field of the treatment.of lung cancer so how do we identify.genetic abnormalities and people who.have cancer what are some of the ways so.biomarkers how do we detect the genetic.abnormalities what are we generally.doing anyone who's diagnosed with the.lung cancer is generally obtaining a.biopsy right so when we get a biopsy we.get a piece of tissue that we then sent.to our colleagues in pathology we're.able to look at it under the microscope.and you know I tell us what type of lung.cancer it is whether it's non small cell.or small cell and then they're actually.able to do these tests that'll tell us.what genes are abnormal EGFR alch and so.on and so forth now you can imagine that.every time somebody progresses on a.medication or the medication I should.say fails the person taking it we would.then go ahead and get a repeat biopsy of.whatever area was growing to try to.understand what abnormality.was there okay or what resistance.mechanism was there now using liquid.biopsy we can actually draw blood or.peripheral blood just like you would get.a regular blood draw a blood count or a.chemistry a kidney or a liver panel we.can now draw a regular blood test it's a.lot more expensive right but we can draw.a regular blood test that they will then.sequence and try to identify what.abnormalities are in your cancer right.because we know that there are.circulating cancer cells that have.cancer cells but also cancer DNA in the.peripheral blood so here's just a quick.schematic this is tumor cells out where.a tumor and the tumor sheds different.proteins or DNA and DNA is sort of the.code right that allow the or tell the.the cancer to grow whatever.abnormalities are in that DNA and by.putting a needle into the vein right yes.you do get normal blood but you're also.able to detect some of these.abnormalities are some of these abnormal.DNA signals and there are many many.companies that are available now that.are doing this we have our own assay.internally it's called the 580 gene.panel which we do on tissue and we're.working on building one on liquid you.know plasma as well and this is sort of.the future and you know please talk to.your doctors about this especially if.you have a cancer that is driven by one.genetic abnormality or one gene so this.is a small a prospective study that we.did looking at 200 patients at the time.of diagnosis could we identify a genetic.abnormality in the blood and would that.change their ultimate care so this is a.map of all the genetic abnormalities.that we identified in all 200 patients.who were newly diagnosed with stage 4.lung cancer who walked into the clinic.and you can see tp53 was the largest.number of patients that we identified.this in and that's actually the most.commonly or altered gene in all cancers.we also identified Ross one which we.talked briefly about already we.identified a few patients with alq and.we did identify patients with EGFR as.well and a smattering of others so we.have four genetic abnormalities that we.have fda-approved match therapies for.but there are about.11 other abnormalities that we have.clinical trials for and we just brought.over a trial for a genetic abnormality.called ret or ret which is very rare but.that is a potential opportunity and and.it's important to note that you do want.to go to a Center where they do have.targeted therapies or targeted.treatments specific to the patient so.when we look at all 200 people who were.identified what worried what were we.able to do or what was the outcome of.those people so 23% of the patients out.of 223 percent of them were matched to.targeted therapy and here is a list of.all the targeted therapies that they.were matched to and there was a 97.percent response rate meaning 97% of.people had evidence of disease that.became smaller or shrunk on the scan.this is a phenomenal number with.chemotherapy or even immunotherapy the.response rates are in the 40 to 50.percent range with targeted therapy were.able to get those response rates into.the 70 and 80% range and that's why this.is so critical to identify this in all.patients another thing that we compared.is we looked at the time it took to.identify an alteration in the tissue.okay and on average it took about 21.days versus about nine days where it.took us to identify the abnormality in.the plasma and time matters when you.meet a patient in clinic who is.symptomatic who has shortness of breath.or cough time matters if I can know that.somebody has a genetic abnormality here.versus here they can be on the treatment.for this amount a period of time and.that also prevents me from starting the.essentially not wrong treatment but the.chemotherapy or the broader treatment as.opposed to the targeted treatment so I.want to thank the group we have a very.large group of folks here and you maybe.could pick out the docs who see you this.is a medical oncology team here is the.surgical team the interventional.pulmonologists and also the radiation.oncologist and happy to take any.questions.

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All these key elements won't take much time, and once the document is signed, you decide the next step. You can either download it to the device or share it in an email or using a link.

A significant profit of CocoSign is that it's suitable with any mobile device, regardless of the operating system. It's the ideal way, and it makes life easier, it's easy.

How to create an e-signature for the Patient Facesheet Update2012 2 Oncology Specialists on iOS?

Creating an electronic signature on a iPad is not at all difficult. You can sign the Patient Facesheet Update2012 2 Oncology Specialists on your iPhone or iPad, using a PDF file. You will note the application CocoSign has created especially for iOS users. Just go to visit CocoSign.

These are the steps you need to sign the form right from your iPhone or iPad:

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  2. By your email to write an account, or sign in with Google or Facebook.
  3. Note the PDF that needs to be signed on the iPad or pull it from the cloud.
  4. Note the space where you want to place the signature; choose 'Insert initials' and 'Insert signature'.
  5. Write down your initials or signature, place them correctly, and save changes to the document.

Once complete, the document is ready for the next step. You can download it to your iPhone and email it. As long as you have a high quality internet connection, you can sign and send documents right away.

How to create an electronic signature for the Patient Facesheet Update2012 2 Oncology Specialists on Android?

iOS has millions of of users, there's no doubt of that, but most cell phone users have an Android operating system. To meet the requirements, CocoSign has developed the app, especially for Android users.

You can recieve the app on Play Market, install it, and you are able to start signing documents. These are the key elements to sign a form on your Android device:

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  2. Choose on '+' to click the document you want to sign, from cloud storage or using your camera.
  3. Note the space where the signature must be placed and then use the popup window to put down your signature.
  4. Place it on the page, confirm, and save the changes.
  5. The final step is to send the signed document.

To send the signed form, just attach it to an email, and it will reach your colleagues right away. CocoSign is the best way to sign various documents every day, all at a comparatively low price. It's time to forget all about distinct mark on hard copy of doc and keep it all electronic.

Patient Facesheet Update2012 2 Oncology Specialists FAQs

Here are the answers to some common confusions regarding Patient Facesheet Update2012 2 Oncology Specialists . Let us know if you have any other requests.

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Is it normal nowadays for U.S. physicians to charge $100+ to fill out a 2-page form for a patient?

I don't know about normal but it's not unusual for doctors to charge for a number of things that used to be free. This includes things like filling out time-consuming forms. This is a task that is taking time that the physician could instead use to see a paying patient. I’m sorry but I doubt that you have any recourse.

When do I have to learn how to fill out a W-2 form?

While I did not study physics this is something that relates to my field as well. One thing to remember is the scope of the field which you are talking about. With physics it might seem narrower than History or Archaeology but I suspect that when you boil it down it isn’t. It would be impossible to cover everything in a subject even going all the way through to gaining a doctorate. The answer you got and posted up is very accurate and extremely good advice. What a lot of it boils down to in education (especially nowadays) is not so much teaching specific facts but teaching themes and how to find Continue Reading

How much will a doctor with a physical disability and annual net income of around Rs. 2.8 lakhs pay in income tax? Which ITR form is to be filled out?

For disability a deduction of ₹75,000/- is available u/s 80U. Rebate u/s87A For AY 17–18, rebate was ₹5,000/- or income tax which ever is lower for person with income less than ₹5,00,000/- For AY 18–19, rebate is ₹2,500/- or income tax whichever is lower for person with income less than 3,50,000/- So, for an income of 2.8 lakhs, taxable income after deduction u/s 80U will remain ₹2,05,000/- which is below the slab rate and hence will not be taxable for any of the above said AY. For ITR, If doctor is practicing himself i.e. He has a professional income than ITR 4 should be filed If doctor is getting a Continue Reading

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