PITTSBURGH — Dizy Kapalka has always loved the great outdoors, so it's no surprise that she quickly mastered the artistry of casting a line in a graceful arch into a cool, clear body of water.

It's why the Cabot, Pennsylvania, resident took up fly fishing a decade ago. And the sisterhood she's found doing it? That's worth a story.

In December 2007, after being bitten by a horse on her left breast, Kapalka discovered she had the same dreaded disease that had claimed her grandmother and sister — breast cancer.

Just 47 years old, she got "all the treatments" required in the months after. But as (bad) luck would have it, the cancer cells began growing again and in 2012 she relapsed, "which was almost harder for me," admits Kapalka, whose daughter was in middle school at the time.

In 2013 at a mentor's suggestion, she added her name to the waiting list for Steel City Dragons' Pink Steel team for breast cancer survivors. After someone sent her info for Casting for Recovery, a national program that provides free fly-fishing retreats to empower women in the same situation, she applied to that, too, because it sounded "nice."

Guess who got their hooks in her first?

Though Kapalka wasn't selected in Casting For Recovery's lottery for the 2013 getaway at the private HomeWaters Club in Spruce Creek, Huntingdon County, she ended up getting in at the last minute as an alternate. It was a life-changing experience.

"I didn't really know what to expect," the 64-year-old says. It had been years since she'd fished, and she'd never fished with a fly. "But it was one of the very best weekends of my life, and I've had a lot of good weekends."

Wellness focused

In 2024, doctors in the U.S. will diagnose more than 300,000 new cases of invasive breast cancer in women, according to the American Cancer Society. Earlier, more thorough screening and increased awareness has helped cut the death rate over the last few decades, but around 42,000 women are predicted to die from the disease in 2024. It's the second leading cause of cancer death in women after lung cancer.

Though it mostly affects older and middle-aged women, half of the women who develop breast cancer are 62 years old or younger when they're diagnosed.

Kapalka's diagnosis resulted in the post-surgical pain of a mastectomy and emotional pain of questioning her survival.

"My daughter was in second grade at the time [of first diagnosis], and you think, 'Am I going to live?'"

Casting For Recovery gave her the help she didn't know she needed.

She arrived at the retreat on Friday evening to find gifts on the bed, followed by a gourmet get-to-know-you dinner with 13 others in the fishing club's lodge. Activities the next day included learning to tie flies and cast without lures, as well as watching on-stream demonstrations wherein instructors picked up the rocks "and showed us some of the bugs that live in the water."

The weekend also included candid but embarrassment-free medical discussions, opportunities for tai chi and yoga, unstructured time for simply relaxing and resting — and perhaps most fun — a campfire marshmallow-roasting session during which the women could talk about the emotional effects of breast cancer.

"I just felt pampered and cared for, and the camaraderie of women," Kapalka says.

But as she says, the actual fishing on Sunday was better still, because the only thing on your mind is the fly dancing on the water.

"You're not thinking about your treatment, or what you've been through," she says. "It's watching for indicators to come down and to see if you can get a hit and catch that fish."

Driving home that afternoon after a graduation ceremony, "I was on cloud nine, like a small kid at Christmas," she says. "I have never felt so healed inside as I did when I left that weekend."

Healing connections

Headquartered in Montana, Casting for Recovery was founded in 1996 in Manchester, Vermont, by a breast cancer reconstructive surgeon and a professional fly fisher as a catalyst for healing.

Nearly 30 years later, it has grown into one of the nation's leading quality-of-life programs for women with breast cancer with the help of national sponsors such as Bass Pro Shops and Cabela's Outdoor Fund, Orvis, Yeti and other foundations and corporations.

The nonprofit has served more than 12,000 women at nearly 900 retreats since its start, and this year will host 60 retreats for more than 800 women, including one for Western Pennsylvania residents on May 17-19 at Seven Springs Mountain Resort in Champion. (Participants were selected in March.) In 2016, it also launched a retreat program exclusively for women with metastatic (stage 4) breast cancer.

Any woman, at any age and in any stage of breast cancer can apply to the program, which combines counseling, medical information and fly fishing to build a focus on wellness instead of illness, says Western Pennsylvania program coordinator Marci Sturgeon. Participants are chosen by a random lottery, and can always apply again if they come up short the first time, as many do.

One of the retreat's main appeals is that it is held outdoors in the fresh air. Or as survivor Tammy Ferraro of Adams explains: "It was just something new and unique and interesting."

Many women are reluctant to attend traditional support groups for fear of hearing too many bad stories, agrees Sturgeon. Baring your soul in a sterile setting such as a hospital or community center meeting room can also be off-putting. But navigating the challenges of cancer while surrounded by nature?

"It's so much more therapeutic on the stream or water with the sun and air than in an office setting," Sturgeon says.

Some of participants, understandably, are very nervous before arriving because they've never even gone camping, let alone picked up a fishing pole. Many are angry or sad about having cancer or what happened to them during treatment, or filled with anxiety about the future.

When you're on the water, retreat attendees say you can allow yourself to let go.

"It just helps meeting other women like yourself," says Ferraro, who underwent a bilateral mastectomy after being diagnosed in 2012, and weathered a year of both chemo and radiation therapy.

She chose a C4R retreat over hospital support groups and loved it in 2014.

"Having something to laugh about is a coping mechanism," Ferraro said.

Yes, she was nervous when she arrived and saw chairs in a circle and a big box of tissues. "I thought, 'I'm not sharing.'" But because the group is so intimate — it's limited to 14 people — "you end up opening up eventually" to the emotional upheaval of your malignancies after getting to know people through workshops.

Former Mt. Lebanon resident Gerrie Delaney, who attended a retreat in 2016 after being diagnosed with two tumors in 2014, agrees the group discussions were healing in a way she never expected.

After a cancer diagnosis, "you're kind of numb," she says. Even saying the word "cancer" was hard. "I'd just break down."

The sense of community she found through Casting For Recovery helped dry many of the 67-year-old's tears.

"At first I thought, 'What am I doing here? I'm not an outdoorswoman, and I'm definitely not a fisherwoman,'" Delaney says.

Yet the experiences the women shared and the things she learned about being outdoors changed her whole perspective.

"It wasn't just intense talking about cancer," Delaney says. "We talked about everything from family to sex lives to how [being diagnosed] changed and affected us. It was just so beautifully done.

"I was so much calmer and happier. I felt like I wasn't alone."

Giving back

Sturgeon agrees the bonding and connections the ladies make over the weekend because of their shared experiences are priceless. Many, in fact, take up fishing seriously after a retreat.

Ferraro, who is still on endocrine treatment but in remission, bought used equipment after her retreat and now fishes regularly around North Park, Pine Creek and Volant. She's also gone on fly fishing trips with other participants to Montana, Utah and Tennessee. Kapalka and Delaney also have become dedicated fly fishers

"It's the calm of being on the water," says Ferraro. "You don't have to hurry up and the worst thing that can happen is to not get a fish."

Some participants have such a life-changing experience that they want to give back and end up becoming volunteers. Ferraro stepped in as a sub with two days' notice in 2016 when a staff member had a family emergency. This year, she'll join Kapalka — who started volunteering in 2014 — as an instructor.

Now a resident of South Carolina, Delaney is also an enthusiastic C4R cheerleader program who spreads the word at fundraisers and events such as health fairs. "I want to pay it forward," she says.

They have good company in lead fly casting instructor Gretchen Fay of Shaler, who runs the nonprofit Stephen Foster Community Center in Lawrenceville whenever she isn't on the water.

An avid outdoorswoman who skis, rock climbs and kayaks, Fay started fishing about 15 years ago to maintain her connection to the outdoors during retirement. She became interested in volunteering with Casting For Recovery after reading (and loving) "Time is a River" by Mary Alice Monroe.

Still relatively new to the sport when she started volunteering in 2010, "I thought it would enhance my skills as a teacher and connect me with people I was sure I'd admire," she says. "And that's exactly what happened."

Every year, she meets different women going through this terrible time, "and they're so strong and courageous and brave," Fay says. "They're such an inspiration and it's just very emotional."

'A spiritual experience'

Fay teaches the Joan Wulff method of fly fishing, which is anchored on a correct grip of the fly rod and proper use of the shoulder, arm and wrist to achieve the perfect cast. The women also learn how to read the weather to see where the fish might be and how to "match the hatch" with flies that mimic aquatic insects in various stages.

Once they catch a fish, they also set the hook, then handle the fish very gently in a catch-and-release that returns it to the water unharmed. "It's a spiritual experience for the ladies," Fay says.

Not to mention that it's good for them physically.

The trauma of surgery can cause tightness in the chest and limit arm and shoulder mobility. The action of casting, Fay says, helps stretch soft tissue and build up arm muscle.

"Just wading in the water helps them use muscles they haven't used before" because it's such a balancing act, she says. For those with mobility issues because of neuropathy, volunteers put their wheelchairs right in the water, "and we're right next to them making them stable."

After they fish on Sunday morning, participants receive a certificate and other mementos and river guides share a few words about their time on the water. There are always lots of tears, along with the sharing of pictures, promises to stay in touch and vows to keep fishing.

Breast cancer offers immediate entrance into a sisterhood you don't ever want to belong to, says Fay. But the friendships survivors make at C4R retreats with women who completely get it is incredibly special

"They come in on Friday night not knowing anyone, and they don't know us, and I swear within 15 minutes there is a connection," she says. "It just blows my mind."

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