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Most cancer deaths in France occur in hospitals. Through in-depth interviews with 18 cancer physicians, we analyse their conceptions of ending cancer treatment and end of life care. All physicians point to specific difficulties with decision-making and team work. Two types of discourse appear granting different values to cancer treatment and end of life care. These two “therapeutic ideologies”, arising when cancer treatment is no longer useful, reveal different conceptions, no doubt crucial to medical practices and attitudes, about cancer trajectory and the role of physicians.