For 22 years I have been coming home to Ballard in the fall. After several weeks in the family cottage, home in Seattle feels strange at first until I’m sucked into the pile of unopened mail and old messages.

But the flight west is always a time for reflection, thinking back to previous summers and looking ahead to the upcoming year.

Three summers ago my best friend from college died of breast cancer on Sept 11. So when I returned home to a message from a local woman asking me to remind readers that October is state and nationally-designated as Breast Cancer Awareness Month it touched a nerve.

Frederica Elliott wrote that her mother had died of breast cancer at a relatively young age; she worried that in this economy women over 40 might skip their annual mammogram.

My friend Lisa had just turned 46 when she died; we both had August birthdays. She had hoped to at least be able to watch her older son graduate from high school but it didn’t work out that way. She was from Maine; when I am back east I sometimes turn toward a voice because I think it is hers.

But even as I thought about Lisa on my flight back to Seattle I was planning ahead, because every Thursday I am surrounded by the most interesting women who happen to be breast cancer survivors. For the last two years I’ve facilitated a Cancer Lifeline writing workshop at the non-profit’s Green Lake location.

Cancer Lifeline is in its 36th year of providing services to anyone whose life has been affected by cancer, starting with a 24-hour support line and now providing support services and classes in multiple locations, with an emphasis on healing arts, from collage through drumming.

Years and years ago I called that lifeline as a caregiver and five years ago I found their writing workshop after my writing partner died of lung cancer. At the writing table there’s a woman with just two more weeks of chemotherapy, a woman celebrating two years cancer free, another 27 years cancer free.

They are scientists, teachers, nurses, actors, anthropologists, but also mothers, daughters, aunts and grandmothers. As one woman wrote at Cancer Lifeline, “The cancer isn’t me.”

At Cancer Lifeline participants don’t write always write about cancer, rarely, in fact. There are too many other things happening in their lives, teaching a grandchild how to bake cookies, standing next to a son during his wedding ceremony, an eagle swooping over Magnolia, the leaves revealing the source of Golden Garden’s name, teaching a daughter to drive.

The stories they do share about receiving their diagnosis, their treatments, their lives after the unplanned and far from pleasant detour as a patient are told to make the journey easier for other women. They all agree that early detection is crucial, that women need to be their own advocates by doing regular self exams, not avoiding their mammograms, and insisting on further tests if their intuition tells them that something is still not right, even if it means challenging a physician.

The incidence of breast cancer is statistically high in Seattle; it’s estimated that one in every seven woman will be diagnosed with breast cancer. Pat, celebrating her second anniversary, counsels women to make sure they are taking Vitamin D supplements because of possible correlation with our lack of sun. “Oil-based,” she specified, “Or else they don’t get absorbed.

There are people in the United States who live far from hospitals or diagnostic centers. Not a problem in Seattle where the region is also a consistent leader in cancer research. The Women’s Imaging Center at Swedish-Ballard performs more than 65,000 diagnostic tests a year; insurance usually covers mammograms. There are some resources for people without health insurance.

I can’t pretend to know what it is like to receive a diagnosis, but I do know what it is like to live with someone in treatment. Mostly it’s an attempt to enjoy day-to-day life like anyone else, plus medical indignities and less certainty about the future.

Early detection is crucial.

Every single person I’ve written within the last five years sees the ways their life has changed and not one of them is bitter, especially as the years since completing treatment accrue.

October is designated as Breast Cancer Awareness month, but awareness isn’t for a month, it’s for every day.

Frederica wrote to me because she lost her mother too early, perhaps before her mother got to garden with grandchildren or see them graduate. Mammograms take a few minutes but along with vigilance they can provide time for more important things like watching the leaves turn gold above Shilshole along with the gift of another year.

Peggy Sturdivant can be reached atlargeinballard@yahoo.com.