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Alternative Medicine – Casting Call

Every fly-fisher carries with him, closer to his heart than even his fly box, a memory of that idyllic day on the river when his line, the water, and even the fish seemed to function as a single, perfect whole. The story usually culminates in catching the legendary fish (which grows bigger on each telling), but if you can get the fisherman to really explore the experience, you’ll learn the catch was only part of the magic. The rest of it — the tranquility, the solitude, the bond with nature — gives the memory its meaning.

For Ed Dudkowski, 61, the treasured day happened in California more than 25 years ago, but he still remembers it vividly. He recalls the cool fall evening and casting his line with more fluidity than ever before, guiding the rod back then forward in just the perfect rhythm, allowing the fly to land gently about 40 feet away on the surface of the water. And yes, he remembers finally catching a trout in that creek, after several years of trying.

“It all came together that evening. It was a sense of complete satisfaction and complete balance,” Dudkowski says of that combined experience unique to fly-fishing: the stimulation of the senses, the thrill of mastering a technical skill like casting, the rejuvenation of exercise, and literally connecting with nature through a rod, a line, and a hook.

Visualizing that transforming evening by the creek, he says, was a healthy distraction that helped sustain and center him when he was diagnosed with an esophageal tumor almost three years ago and underwent months of chemotherapy and radiation. After his treatment concluded, he returned to his love of fly-fishing and even made the sport an integral part of his recovery.

“Fly-fishing got me through it,” the Marin County, California, resident and videographer says about the critical role his life-long passion played in his battle with cancer. “It takes you to a whole new level. You find yourself in an environment that’s untouched. When you connect with a fish, you connect with the wild. It feeds the soul.”

Two days away

By the time Dudkowski attended a two-and-a-half-day fly-fishing retreat in northern California in the fall of 2005, he was cancer-free. The retreat was organized by Reel Recovery, a national group based in Needham, Massachusetts, that provides the catch-and-release event in locations throughout the country to men at any stage of a serious cancer diagnosis.

Three Colorado fly-fishermen founded Reel Recovery in 2003. One of the founders, Stewart Brown, continued to fish after he was diagnosed with brain cancer. Coy Theobalt, program director and lead facilitator for Reel Recovery, became friends and fished with Brown a year before his death in 2003. Theobalt says the fishing took on a special significance during that time. “We laughed a lot and cried together,” he says. “Being around Stu helped me see how important laughter is in our lives. Carpe Diem. Stewart did that to the max.”

The respite that fly-fishing provided for Brown during his battle with cancer helps the participants at the retreats as well, according to Theobalt. Stan Golub, executive director for Reel Recovery, agrees: “When they’re out in the water, they forget about the cancer. Having the river flow by, getting immersed in casting, putting the fly out there. There’s a tranquility in that. There’s a joy in catching a fish. There’s an amalgamation of experiences there that are completely divorced from cancer.”

According to Theobalt, men who attend are surprised to find that the event offers more than the two days set aside for fly-fishing. “Fishing is the hook that gets men to the retreat,” he says. With a background in marriage and family therapy and corporate training, Theobalt created Reel Recovery’s “Courageous Conversations” as a way to encourage men to explore their feelings about their illness. These structured discussions gradually build from talking about favorite foods and colors, to experiences with fishing, and then to deeper issues such as the kinds of cancer participants have and how they cope.

“In general,” Golub says, “men tend to be stoic, independent, reticent about their suffering.” He explains, however, that orienting the whole event around fly-fishing helps change that. It serves as a bonding activity that can ultimately lead men to have the most important conversations of their lives. Fly-fishing in particular, Theobalt adds, offers an experience that can break down the adult anxieties and fears participants may feel but hesitate to share in their everyday lives. “Let the kid emerge,” Theobalt emphasizes. “Fishing allows us to be childlike without being childish. The child is an advocate in their battle with cancer. When people laugh and are playful, they’re healthier.”

Women on water

Men aren’t the only ones enjoying the healing benefits of fly-fishing. Casting for Recovery, based in Manchester, Vermont, has offered retreats to women with breast cancer since 1996. According to Executive Director Seline Skoug, this year more than 500 participants will attend the weekend retreats in locations throughout the US and Canada. Trained facilitators, including a psychotherapist, a healthcare professional such as a physical therapist or nurse, and four fly-fishing instructors staff each retreat. About 600 men and women volunteer, including many experienced fly-fishers in the participating communities, says Skoug.

Before spending the final day of the retreat practicing catch-and-release fishing, women learn about equipment, the basics of fly-casting, entomology (the study of insects), and knot-tying. When they finally get the chance to put their knowledge to the test, the new fly-fishers tend to jump in with both feet. “We can’t get them out of the water,” Skoug says. “It’s like trying to get your kids off the playground.”

Kathy Sarnes was 41 and had just been diagnosed with breast cancer when she attended her first Casting for Recovery retreat in 1996. The residential mortgage lender from Vermont had never fly-fished before and says she found the entire experience transforming. “The introduction to fly-fishing was a re-introduction to nature, something none of us considered. Nor did we realize what a positive impact that would have on us.”

The water component of fishing provided the most therapy for her: Its calming and spiritual qualities can help a person cope with cancer, regardless of the outcome of the disease, she explains.

“When you go to these retreats, you’re out of that clinical environment. You don’t have time to focus on that disease,” Sarnes says. “It’s wonderful to have your mind taken away to another place.”

Sarnes, who underwent bilateral mastectomies and reconstructive surgery in 2002 after a recurrence and is cancer-free today, has continued to fly-fish and even began volunteering as a fly-fishing instructor for Casting for Recovery a year after attending her first retreat.

Fishing as medicine

Along with providing an escape from the anxieties of breast cancer, fly-fishing is good for arm health and may help prevent lymphedema, says Sandra Vermeulen, a radiation oncologist with the Swedish Cancer Institute at Northwest Hospital in Seattle, Washington. Lymphedema, the swelling that can occur after breast cancer treatment, affects mobility and increases risk of blood clots or infection.

Anything that helps promote musculature in the arm can aid in prevention, according to Vermeulen, an avid fly-fisher for almost 20 years. The key? “Keeping toned but not overdoing it,” she says. The gentle exercise fly-fishing offers, especially casting — gracefully directing a fly with a rod — fits that criterion. The movement involved in casting encourages drainage of the lymph fluid in the arm, thereby increasing mobility and reducing infection and the formation of blood clots. Recent medical studies also support Vermeulen’s opinion that exercise can be effective in helping to manage lymphedema.

With the financial support of Northwest Hospital in Seattle, Vermeulen and her husband, also a fly-fisher, started offering free retreats, called “Northwest Casting Call,” in 2005 for women in the Seattle area who have breast cancer or are in recovery. With a spring and fall retreat planned for this year, Vermeulen says she hopes the current limit of 20 women will expand by 10 each year. The event includes two half days of fly-fishing basics and casting practice and a half-day float trip down the Yakima River with experienced guides.

Although the physical benefits of fly-fishing may not address a specific side effect for male cancer patients, Dudkowski still found the sport’s gentle exercise essential to his recuperation after chemotherapy and radiation. He practiced casting for a half-hour a day for about six weeks. The exercise, he says, helped him regain his arm strength. Wading in the water while he fished in Napa made his legs stronger. By May of 2004, he was in prime condition to go on a special fishing trip at a friend’s resort in Mexico.

Unfortunately, by spring of this year, Dudkowski had some recurrence of his tumor. But again, he looked to fly-fishing to help him through. After hearing the news, Dudkowski recalls, “My son called and said, ‘We’re going down to Mexico to do some fly-fishing.'” Dudkowski says cancer has taught him to enjoy every moment and to treat himself well. “Treating yourself well,” he adds, “is going fly-fishing.” Focus on Flies

One aspect of fly-fishing offers practitioners a chance to de-stress and unwind without leaving the house. Fly-tying, which involves fastening to a hook a combination of synthetic or natural materials that mimic what a fish might eat, can be a creative outlet, one that even rises to the level of meditation.

“While I’m creating these works of art, I’m fishing in a way,” says Rob Nicholas, who has been tying flies for about 22 years and who also has a professional guide service that offers trout fishing trips on the Housatonic and Farmington rivers. “I visualize standing in the river, the rise of the fish.” Around his desk in his northwest Connecticut home sit organized trays and a glass-covered typesetter drawer full of a colorful array of materials, such as beads, hooks, peacock feathers, elk and deer hair, foam, and chenille.

A fly can be as simple or as elaborate as a creator wants and can imitate just about any kind of fish food, like grasshoppers, ants, or beetles.

“The combinations are endless,” says Nicholas, sipping a cup of hot tea while he surveys the tiny piece of black foam he just cut to be the body of a black ant fly. He explains that the possibilities and challenges of creating the right size, shape, and color combination to make a fly effective are what transform the utilitarian function of fly-tying into a relaxing, meditative art form. “You totally get lost, immersed in what you’re doing,” he says.

Fly-tying holds special benefit for people with cancer, according to Virginia Borges, who ties flies and is a medical oncologist and assistant professor of medicine at the University of Colorado Health Sciences Center. With chemotherapy, she says, patients’ short-term memory can decline, but the repetitive concentration required to tie flies can help improve it.

“Most survivors have a hard time with their re-entry to life. They tend to feel de-conditioned,” she adds, explaining that women recovering from breast cancer treatment, for example, often become frustrated with how long it takes to regain strength and stamina. “Having a small goal,” says Borges, “like making your own set of flies, is uplifting.”

Strength in Motion

Fly-fishing provides emotional benefits to those coping with the challenges of cancer in ways that other activities don’t, according to Virginia Borges, a fly-fisher and medical oncologist. To outsmart a fish, she explains, the pursuit requires a concentration that, unlike the repetition of walking or biking, doesn’t allow the mind to wander. This focus can serve as a healing break from the consuming anxieties of illness, she says.

In addition, some of the physical benefits include:

Strength and flexibility

The practice of casting can be especially helpful for women with breast cancer who have problems with range of motion in the arm.


Walking along the water or wading in it gently increases cancer survivors’ endurance, especially after they finish their treatment, which often leaves them feeling out of shape.

Core power

Standing straight with stability while casting a line and fishing are musts for good anglers. Maintaining alignment improves the trunk muscles, a particular benefit to adults with cancer who can lose strength in this area during the course of illness.


Manipulating a fly rod and tying flies can help improve hand movement, which may be hindered as a result of cancer treatment.

Hand-eye coordination

Casting and fly-tying boost hand-eye coordination, which is sometimes diminished by cancer.

Motor skills

The exercise and activities of fly-fishing (casting, walking, and fly-tying) can help adults with cancer regain overall muscle movement.

When practiced consistently, the sport offers a variety of activity that is so consuming and invigorating, the physical benefits are often absorbed without cancer survivors even realizing they’re making an effort. Fly-fishing is intense in a positive way, Borges says. “It doesn’t feel like exercise.”

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