Until quite recently, I saw little connection between fly fishing and health service provision apart from the fact that many doctors are also fly fishers. A year or so ago, however, I became aware of the growing and remarkable success of Casting for Recovery (CfR), a charity which uses fly fishing to provide education, relaxation and support for breast cancer survivors in the pretty and peaceful surroundings to which the sport so often takes us.

The Sunday before last found me at Kimbridge, on the River Test, privileged to have been invited to act as one of 13 guides at a CfR retreat for 13 women at various stages of recovery from breast cancer – and what fun we had!

The participants had gathered on Friday afternoon and spent the evening getting to know each other and the staff, being issued with fishing tackle and watching a casting demonstration. Saturday had seen them heading for the water to be shown how to assemble their tackle, to tie fishermen’s knots and for a casting lesson. After lunch, and although any participant was able to see one of the medical staff or the counsellor at any time, there was 45 minutes of medical education followed by an ever-popular entomology session. Each participant was then given a box of flies and invited to select artificials to match the naturals. A further casting lesson was followed by an evening relaxation session and group counselling.

Through the generosity of Clay and Sue Brendish, the owners, the participants – each with a guide – spent Sunday morning fishing on two lakes well stocked with trout. Every one of them caught fish, and the thrill and excitement were palpable and infectious.

CfR is run immensely professionally by Sue Hunter, who has twice had breast cancer herself, and who has fished for the England Ladies fly fishing team eight times, captaining it twice. Each retreat is staffed by a team of people including a coaching coordinator, two further qualified instructors; an equipment coordinator; a breast care nurse or a clinician with breast cancer experience; a counsellor; and one or two retreat assistants, as retreat coordinator Sue works closely with them all to make sure that retreats run smoothly.

Sue discovered fly fishing soon after her second mastectomy in 1999, and found the pastime particularly helpful in handling her recovery. Determined that other women should have the opportunity to experience the therapeutic value of fly fishing, and after hearing of an organisation in the US that was doing just that, Sue and some of her colleagues from the England Ladies Flyfishing Association decided to set up Casting for Recovery UK and Ireland and offer fly fishing retreats for women with breast cancer.

CfR was established with sponsorship from the Countryside Alliance. The first retreat was run very successfully in September 2007. Thereafter, four were run in 2008, seven in 2009, and a further four are being held in 2010 – the reduction in numbers being down to funding issues and to the need to build sustainability into the programme which is clearly here to stay.

It costs £6000 to run a retreat. While the angling community has been very generous, a couple of people donating entire retreats, others part-sponsoring them, and many sending “support in kind” (Orvis UK provides all the tackle, for example, and people send boxes of flies and the like), funding is a perpetual concern.

Any woman who has or has had breast cancer is eligible to participate in a retreat as long has she has medical clearance from her doctor. Participants may, therefore, be at any stage of treatment and recovery. Among CfR’s objectives is to provide each participant with an experience that focuses on wellness, rather than illness, and empowerment as opposed to helplessness.

Through word of mouth and, increasingly, through doctors who are becoming aware of the benefits, CfR’s retreats are over-subscribed. A maximum of 14 applicants are selected by ballot and participation is free.

Fisheries are chosen with care. Each must have an acceptable hotel nearby and be accessible and safe, with adequate life-saving equipment and proper facilities. Small, clear water fisheries without casting platforms are preferred. The sizes of the stocked trout are important, too; women recovering from breast cancer should not be expected to wrestle with huge fish (see picture).

So, what can we do to help so excellent and meticulously managed an organisation? Well, we can dip into our pockets. Funding is vital, of course, and the angling community has already shown itself to be remarkably generous. Awareness is important, too. If more people can be made aware of CfR’s outstanding work, it will be able to do more of it.

Casting for Recovery UK & Ireland’s website is at www.castingforrecovery.org.uk. They can be contacted at PO Box 3611, Slough, Berkshire, SL3 3BY, or by email: sue.hunter.cfr@gmail.com.

Peter Lapsley is patient editor of the BMJ.