Van der Weijden won a three-way sprint in the inaugural event with a better-angled finish under a steady rain.
"I think the leukemia taught me to think step by step," Van der Weijden said. "When you're lying in the hospital bed and feeling so much pain and feeling so tired, you don't want to think about next week or next month, you're only thinking about the next hour.
"You just (have to) be patient. You lie in your bed and just wait. It's almost the same strategy I've used here, to stay in the pack, to be patient, and stay easy just waiting for your chance."
David Davies of Britain and Thomas Lurz of Germany drifted to the outside at the finish and settled for silver and bronze.
Van der Weijden reached up to slap the yellow touchpad in 1 hour, 51 minutes, 51.6 seconds. Davies was 1.5 seconds behind, and Lurz finished 2.0 seconds back.
"If there is anyone in the field that can beat me, that guy is an absolute legend," Davies said of van der Weijden. "He's a great guy. He's obviously been to the depths in his personal life and to come back is a great story. Lance Armstrong epic."
Van der Weijden was diagnosed with leukemia in 2001. He came back in 2003 and began swimming faster than before he had the disease. He now commits a large portion of his time to raising awareness for leukemia.
"Because of the treatment I got, the stem-cell transplants, I had the luck to recover," Van der Weijden said. "The stem-cell transplants are because of research worldwide for cancer. So everyone who donates money, donated money in the past, I'm grateful too, or otherwise I wouldn't be here."
After the win, Van der Weijden raised his arms in the air and pumped his fists as he walked around the dock. He was hoisted on the shoulders of his fellow countrymen and pointed a finger toward to sky to show he was No. 1.
Davies was at or near the lead from start to finish on the 10 kilometer (6.2-mile) course and opened up a five or six body-length lead with a few hundred meters (yards) remaining. He couldn't hold it, though.
"It's going to take a while for it to sink in," Davies said. "At the last bit, I didn't know what was going on."
Davies received medical attention after the race.
"I just wanted to lie down and have a sleep, but before I knew it I was on a stretcher," he said.
Along with Vladimir Dyatchin of Russia, Lurz was one of the pre-race favorites, having won the world title in this event in 2004 and 2006.
"I knew Maarten finished well, so it was important to stay with him," Lurz said.
Dyatchin, who won back-to-back world titles in 2007 and 2008, never contended and was disqualified after touching 12th.
Despite the rain, the race was held in ideal swimming conditions at Shunyi Rowing-Canoeing Park. With the air temperature at 21 degrees Celsius (70 Fahrenheit), it was a decent contrast with the 27 degree (81 Fahrenheit) water. The water at the indoor swimming facility in Beijing is about 26 degrees (80 Fahrenheit).
The 25 competitors swam four laps each around the artificial body of water, with coaches riding close by along the shore on bicycles.
Van der Weijden won the 25km race at this year's world championships and was fourth in the 10km. His flexibility in adapting to different tactics and speed across various distances makes him a contender in almost any open water race.
"I need to learn to swim straight. I know that sounds silly," Davies said.
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