The After. Cancer Podcast

ep 16: When Certainty Disappears: Living With Metastatic or Chronic Cancer

A metastatic cancer diagnosis changes more than a treatment plan. It changes a person's relationship with time, uncertainty, planning, and the future itself. In this episode, Dr. Leslie Waltke explores the often misunderstood reality of living with metastatic (stage IV) or chronic cancer. This is not a conversation about giving up. It is a conversation about building a meaningful life when certainty is no longer available. Together, we discuss scan anxiety, the loneliness of looking well, the challenges of making life decisions without clear timelines, the role of exercise and cancer rehabilitation in metastatic disease, and why people living with stage IV cancer deserve to be understood—not stereotyped. This episode is brought to you in partnership with CURE. In This Episode • Why metastatic cancer changes a person's relationship with the future • The psychological burden of living with ongoing uncertainty • Scanxiety and the endless cycle of waiting for results • The loneliness of looking healthy while carrying invisible burdens • The planning paradox: trips, retirement, finances, and major life decisions • Why strength, exercise, and cancer rehabilitation matter in metastatic disease • How uncertainty can clarify values and priorities • Moving forward without toxic positivity Reflection Prompts 1. What decision in your life is uncertainty making difficult right now? 2. What is one thing people misunderstand about living with metastatic disease? 3. What advice would you give to someone newly diagnosed with metastatic cancer? Episode Chapters 00:00 – When Certainty Disappears 03:10 – Living Between Categories 05:20 – Survivor, Patient, or Both? 06:47 – The Endless Waiting Room 08:11 – The Loneliness of Looking Well 09:30 – The Planning Paradox 11:40 – Why Function Matters More Than Ever 14:09 – What Uncertainty Teaches Us 15:52 – Building a Meaningful Life Without Certainty 16:15 – A Message to Those Living With Metastatic Cancer 17:22 – Reflection Prompts & Closing Thoughts Resources Mentioned Episode 8: Survivorship by the Numbers: https://youtu.be/gntcH3lvTDs The After. Cancer Podcast YouTube Playlist: https://www.youtube.com/@aftercancerpodcast Waltke Cancer Rehabilitation Academy: https://www.drlesliewaltke.com ABCD: After Breast Cancer Diagnosis: https://abcdbreastcancersupport.org

ep 15 - Can You Trust Your Body Again After Cancer? Why Your Body Is Not Betraying You

Many cancer survivors reach a point where they no longer trust their bodies. Cancer appeared inside the very body that was supposed to protect them. Treatment changed how their body looks, feels, and functions. It is understandable why so many people describe the experience as betrayal. But what if there is another way to understand the story? In Episode 15, Dr. Leslie Waltke explores the idea that a random cellular error should not define your relationship with your body for the rest of your life. Drawing on biology, rehabilitation science, and patient experiences, this conversation reframes survivorship through the lens of partnership rather than resentment. You will learn why the human body is remarkably resilient, how adaptation drives recovery, and why movement, exercise, and rehabilitation are powerful acts of collaboration with your body after cancer. This episode is an invitation to consider a different possibility: your body may not have betrayed you. It may be the same body that has been fighting for you every second of every day. Chapters 00:00 – Opening Hook: Did Your Body Betray You? 01:19 – Welcome & Season One Update 02:35 – What Your Body Was Doing Before Cancer 04:15 – The Biology of Protection and DNA Repair 06:40 – Why 'Betrayal' May Not Be the Right Story 09:20 – The Survivor Who Was Angry at Her Body 12:05 – Resentment vs. Partnership 14:00 – The Science of Resilience and Adaptation 17:10 – Why Cancer Rehabilitation Works 19:15 – Grief, Identity, and Not Recognizing Your Body 22:05 – Movement as Communication 24:40 – A Random Cell Should Not Control the Next 30 Years 27:10 – The Stories We Tell Ourselves 29:30 – Reflection Prompts 31:05 – ABCD Community Shout Out 32:00 – Next Episode: Living With Metastatic Disease Key Topics Discussed • Why many survivors feel their body betrayed them after cancer • The difference between betrayal and biological vulnerability • How the body repairs DNA and protects itself every day • The science of resilience and adaptation • Why rehabilitation works after cancer • Movement as communication and partnership • Grief versus war in the relationship with your body • How the stories we tell ourselves shape recovery • Building a stronger future through partnership rather than resentment Reflection Prompts 1. If you viewed your body as a teammate instead of an enemy, what is one thing you would start doing differently this week? 2. What has your body done for you since your cancer diagnosis that you rarely give it credit for? 3. What story have you been telling yourself about your body since cancer—and is that story helping you build the future you want? Related Episodes Episode 1 – Cancer Labels and Claiming Identity https://youtu.be/09HpIAh92sk?si=ZYprI812Tmd5tKtH Episode 2 – The Finish Line Myth https://youtu.be/UUggVScpzY8?si=_TFewtGFLg-gqcT7 Episode 3 – The Cancer Comparing https://youtu.be/LDh4mGI9tWo?si=5ggmnul2s8H2YfkJ Episode 4 – Living in a Hyper-Vigilant Body https://youtu.be/h8p7bvUWBew?si=dA8hWjfcylw3XAJ5 Episode 5 – Why Your Brain Stops Processing After a Cancer Diagnosis https://youtu.be/RxK0WmMgaJE Episode 6 – Survivor Guilt in Cancer https://youtu.be/TfO810C5dfc\ Episode 7 – Battle Language in Cancer https://youtu.be/0zr3NZq0D8o Episode 8 – The Reality of Cancer Survivorship Today https://youtu.be/gntcH3lvTDs Episode 9 – Cancer Explained: What Cancer Actually Is and How It Starts https://youtu.be/k9_NkHp1rZ8 Episode 10 – Cancer Surgery 101 https://youtu.be/ESWK-oB3muM Episode 11 – Chemotherapy Explained https://youtu.be/jdJc3u7HMlU Episode 12 – Radiation Therapy 101 https://youtu.be/N09j9ViFmm0 Episode 13 – Exercise During & After Cancer Treatment https://youtu.be/V3gnQtdRRYE Episode 14 – The Relationship Earthquakes https://youtu.be/KrbOzeEwLww Community Shout Out ABCD (After Breast Cancer Diagnosis) provides free, virtual, personalized emotional support by matching anyone impacted by breast cancer with a trained volunteer mentor who has a similar lived experience. Abcdbreastcancersupport.org About the Host Dr. Leslie Waltke, PT, DPT, is an oncology physical therapist, educator, speaker, and founder of the Waltke Cancer Rehabilitation Academy. She serves as Cancer Rehabilitation Coordinator for Aurora Health Care and is dedicated to helping people recover, understand and navigate life during and after cancer. About the Podcast The After. Cancer Podcast, in partnership with CURE, is rooted in medicine, spoken in human. Each week, Dr. Leslie Waltke explores the physical, emotional, and practical realities of life during and after cancer.

Ep 14 - The Relationship Earthquakes

The Relationship Earthquakes: How Cancer Changes Marriages, Friendships, Families, Intimacy, Parenting, and the Invisible Expectations Between People Cancer does not just change bodies. It changes relationships. In this episode of The After. Cancer Podcast, Dr. Leslie Waltke explores the often-unspoken ways cancer can reshape marriages, friendships, family dynamics, parenting, intimacy, communication, and support systems. While many people expect the physical challenges of cancer, few are prepared for the relationship aftershocks that can continue long after treatment ends. Dr. Waltke discusses why some relationships become stronger while others fracture, how cancer can expose existing patterns within relationships, and why survivors often find themselves carrying not only the weight of their diagnosis but also the emotions and expectations of the people around them. Topics include caregiver dynamics, friendship loss, emotional support, parenting through cancer, body image, intimacy, communication challenges, changing identities, and the difficult reality that cancer sometimes reveals which relationships are capable of growing and which are not. If your relationships changed after cancer—or if you have struggled to explain those changes to others—this episode offers validation, insight, and perspective on one of the most common yet least discussed parts of the cancer experience. This podcast is in Partnership with CURE. Visit CUREtoday.com Resources Mentioned - ABCD: After Breast Cancer Diagnosis - The After. Cancer Podcast Community Related Episodes • Episode 1: Cancer Labels and Claiming Identity: Who Decides What to Call You? https://youtu.be/09HpIAh92sk?si=ZYprI812Tmd5tKtH • Episode 2: The Finish Line Myth: Why Survivorship May Feel Harder Than You Expected https://youtu.be/UUggVScpzY8?si=_TFewtGFLg-gqcT7 • Episode 4: Living in a Hyper-Vigilant Body: Why Your Body Stays on High Alert After Cancer https://youtu.be/h8p7bvUWBew?si=dA8hWjfcylw3XAJ5 • Episode 6: Survivor Guilt in Cancer https://youtu.be/TfO810C5dfc • Episode 15: Your Body Is Not Betraying You – coming soon! Community Shout Outs A special thank you to ABCD (After Breast Cancer Diagnosis) for their ongoing support of people living with and beyond breast cancer. ABCD provides free, personalized emotional support by matching individuals impacted by breast cancer with trained volunteer mentors who have lived similar experiences. About the Host Dr. Leslie Waltke is an internationally respected oncology physical therapist, educator, speaker, consultant, and cancer rehabilitation leader. For more than three decades, she has helped people living with and beyond cancer navigate recovery, function, survivorship, and quality of life. She is the founder of the Waltke Cancer Rehabilitation Academy, host of The After. Cancer Podcast, and a national advocate for improving access to cancer rehabilitation and survivorship care. About the Podcast The After. Cancer Podcast is rooted in medicine and spoken in human. Hosted by oncology physical therapist Dr. Leslie Waltke, this podcast explores the physical, emotional, and practical realities of cancer and survivorship. Each episode combines evidence-based education, clinical insight, and real-world experience to help survivors, caregivers, and healthcare professionals better understand life during and after cancer. Subscribe and Follow If you found this episode helpful, please subscribe, follow, leave a review, and share the podcast with someone who may benefit from these conversations. Your support helps more people living with and beyond cancer discover the information, validation, and community they deserve. Join the After Cancer Podcast email list and get new episodes delivered to your inbox: https://drwaltke.myflodesk.com/aftercancer Work With Dr. Waltke Dr. Waltke is available for CEU and CME education programs, keynote speaking engagements, cancer survivorship presentations, oncology rehabilitation consulting, health system program development, and professional/interdisciplinary healthcare education. To learn more about educational programs, speaking engagements, and consulting services through the Waltke Cancer Rehabilitation Academy, visit WaltkeAcademy.com. Contact Information Website: WaltkeAcademy.com LinkedIn: Dr. Leslie Waltke Topics Cancer survivorship, relationships after cancer, marriage and cancer, friendship loss, caregivers, caregiving, family dynamics, intimacy after cancer, body image, parenting with cancer, emotional support, communication, survivorship challenges, cancer recovery, cancer relationships, caregiver burden, survivorship psychology, life after cancer, oncology rehabilitation, Dr. Leslie Waltke If you are navigating cancer, survivorship, treatment side effects, or the emotional realities of life after diagnosis, The After. Cancer Podcast is here for you!

ep 13 - Why Cancer Survivors Stay Exhausted Even When “Active.” Activity, Exercise and Cancer Rehab

What if being exhausted all day does not actually mean your body is getting stronger? In this episode of The After. Cancer Podcast, Dr. Leslie Waltke breaks down one of the most misunderstood topics in cancer survivorship and recovery: the difference between activity, exercise, and rehabilitation. Many cancer survivors spend their days physically and emotionally exhausted, yet still feel weak, deconditioned, stiff, or unable to fully return to life after treatment. Why? Because movement is not always the same thing as exercise — and exercise is not the same thing as rehabilitation. In this episode, Dr. Waltke explains how cancer treatment affects strength, endurance, balance, mobility, and overall function, while also helping listeners understand why intentional movement matters so much during and after cancer treatment. She discusses fatigue, deconditioning, fear of movement, rehabilitation needs, and the critical role of physical therapy and oncology rehabilitation in helping people regain confidence, independence, and participation in life. This conversation is both deeply practical and deeply human — rooted in medicine, spoken in human. Topics Covered • The difference between physical activity, exercise, and rehabilitation • Why cancer survivors often remain exhausted after treatment • Lifespan vs. health span • How cancer treatment affects muscles, endurance, balance, mobility, and confidence • Why exhaustion does not always equal conditioning • The role of rehabilitation after cancer treatment • Fear, deconditioning, and loss of trust in the body after cancer • Exercise during and after chemotherapy, radiation, surgery, and hormonal therapy • Why movement is tied to identity, confidence, and participation in life • How rehabilitation can improve strength, endurance, balance, and function • Why individualized exercise prescription matters in cancer recovery Episode Chapters 00:00 – Episode Hook 02:18 – Podcast Intro 04:15 – Lifespan vs Health Span 07:28 – Activity vs Exercise 11:40 – Why Exercise Matters After Cancer 16:05 – What Rehabilitation Really Means 20:32 – Symptoms That May Need Rehab 24:10 – Fear, Deconditioning, and Loss of Confidence 28:42 – Why Movement Is Tied to Identity 32:15 – Exercise Does Not Need to Look Extreme 35:05 – Reflection Questions and Closing Thoughts Resources Mentioned • American College of Sports Medicine (ACSM) Exercise Guidelines for Cancer Survivors • Oncology rehabilitation and cancer physical therapy • Evidence-based exercise during and after cancer treatment • CURE – cancer education, support, and survivorship information For more information, visit CUREtoday.com. Related Episodes • Episode 9 – Cancer Explained: What Cancer Actually Is and How It Starts https://youtu.be/k9_NkHp1rZ8 • Episode 10 – Cancer Surgery 101 https://youtu.be/ESWK-oB3muM • Episode 11 – Chemotherapy 101 https://youtu.be/jdJc3u7HMlU • Episode 12 – Radiation Therapy 101 https://youtu.be/N09j9ViFmm0 Community Shout Outs A special thank you to ABCD: After Breast Cancer Diagnosis for the meaningful work they do connecting breast cancer survivors and mentors through free personalized support programs. To learn more about ABCD or become a mentor or mentee, visit abcdbreastcancersupport.org. About the Host Dr. Leslie Waltke is an internationally respected oncology physical therapist, educator, speaker, and advocate helping people live fully with and beyond cancer. She is the Founder of the Waltke Cancer Rehabilitation Academy and host of The After. Cancer Podcast. About the Podcast The After. Cancer Podcast is a space for the emotional, physical, and real-life challenges that often come after a cancer diagnosis. This podcast is for people living with and beyond cancer, the people who love them, and the clinicians who care for them. Each episode explores the real experiences of life after a cancer diagnosis — with honest conversations, survivor voices, and clear, compassionate guidance rooted in medicine and spoken in human. Work With Dr. Waltke Dr. Leslie Waltke is available for healthcare keynote speaking, conference presentations, hospital and cancer center consulting, continuing medical education (CME), continuing education unit (CEU) programming, oncology rehabilitation program development, and survivorship education through the Waltke Cancer Rehabilitation Academy. To learn more about educational opportunities, consulting, speaking engagements, or cancer rehabilitation training programs, visit WaltkeAcademy.com. Contact Information Website: WaltkeAcademy.com info@waltkeacademy.com Topics Cancer rehabilitation, oncology physical therapy, exercise after cancer, cancer survivorship, cancer fatigue, physical therapy after cancer, chemotherapy recovery, radiation recovery, cancer exercise, deconditioning, oncology rehab, cancer recovery, neuropathy, survivorship care, health span, quality of life after cancer

ep 12 - Radiation Therapy Explained: What It Really Does to the Body

Radiation therapy is one of the most common cancer treatments in the world, yet many people begin treatment without fully understanding what radiation actually does inside the body. In Episode 12 of The After. Cancer Podcast, Dr. Leslie Waltke explains radiation therapy in clear, compassionate language—breaking down how radiation works, why side effects occur, and how the body heals afterward. This episode explores: • How radiation damages cancer cells • Why healthy tissue can also be affected • Fatigue, skin changes, fibrosis, and tightness • Why radiation side effects can continue long after treatment ends • The importance of stretching, movement, and exercise • How rehabilitation helps people recover function and quality of life CHAPTERS: 00:00 Introduction 00:14 What radiation therapy actually is 01:45 Why radiation sounds frightening 02:50 How radiation damages cancer cells 04:10 Why healthy tissue is affected too 05:15 Skin changes, fibrosis, and tightness 06:30 Fatigue during radiation therapy 07:20 Why radiation is highly precise 08:00 The radiation oncology team explained 09:00 Recovery, stretching, and rehabilitation 10:00 Exercise and long-term survivorship 10:30 Reflection + closing thoughts 11:05 ABCD shoutout + outro This is Part 4 of the 4-part Cancer 101 series. This podcast is brought to you in partnership with CURE. For more information, visit CUREtoday.com. Resources Mentioned in This Episode • ABCD – After Breast Cancer Diagnosis (free, virtual emotional support) https://abcdbreastcancersupport.org • ABCD Mentor Program https://abcdbreastcancersupport.org/get-involved/become-a-mentor/ Episodes Mentioned / Related ACP Episodes Episode 9 – Cancer Cell 101 https://youtu.be/k9_NkHp1rZ8 Episode 10 – Cancer Surgery 101 https://youtu.be/ESWK-oB3muM Episode 11 – Chemotherapy 101 https://youtu.be/jdJc3u7HMlU Episode 13 – Exercise During and After Cancer Treatment - coming soon! Community Shout Outs ABCD – After Breast Cancer Diagnosis https://abcdbreastcancersupport.org https://abcdbreastcancersupport.org/get-involved/become-a-mentor/ ABCD: After Breast Cancer Diagnosis provides free, personalized emotional support to anyone impacted by breast cancer, anywhere, at any stage. About the Host Dr. Leslie Waltke is an internationally respected oncology physical therapist, educator, and advocate for evidence-based cancer survivorship care. About The After. Cancer Podcast The After. Cancer Podcast explores the real experience of living with and beyond cancer — the side effects, the fear, the identity shifts, and the path forward that few people talk about. Subscribe / Follow CTA • Follow on YouTube and your favorite podcast platform • Join the email list: https://drwaltke.myflodesk.com/aftercancer • Share The After. Cancer Podcast with someone who needs it Professional Education (Waltke Cancer Rehabilitation Academy) Dr. Leslie Waltke is available for keynote speaking, CME and CEU education, consulting, and cancer rehabilitation program development through the Waltke Cancer Rehabilitation Academy. Learn more: https://www.waltkeacademy.com Contact Information info@WaltkeAcademy.com drlesliewaltke.com Topics radiation therapy explained, radiation side effects, fibrosis after radiation, cancer fatigue, oncology rehab, cancer rehabilitation, cancer survivorship, cancer education, After Cancer Podcast f you are navigating cancer, survivorship, treatment side effects, or the emotional realities of life after diagnosis, The After. Cancer Podcast is here for you!