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Pain is generally an unpleasant feeling in response to an event that either damages or can potentially damage the body's tissues. There are four main steps in the process of feeling pain: transduction , transmission, perception , and modulation .  The nerve cells that detect pain have cell bodies located in the dorsal root ganglia and fibers that transmit these signals to the spinal cord.  The process of pain sensation starts when the pain-causing event triggers the endings of appropriate sensory nerve cells . This type of cell converts the event into an electrical signal by transduction. Several different types of nerve fibers carry out the transmission of the electrical signal from the transducing cell to the posterior horn of spinal cord , from there to the brain stem , and then from the brain stem to the various parts of the brain such as the thalamus and the limbic system . In the brain, the pain signals are processed and given context in the process of pain perception . Through modulation, the brain can modify the sending of further nerve impulses by decreasing or increasing the release of neurotransmitters . 
In patients who have an aggressive form of high-grade superficial bladder cancer and those who have not responded or who have recurrent bladder cancer in spite of treatments mentioned above, a more aggressive form of treatment may be warranted. This is usually in the form of a major surgical procedure called radical cystectomy. It entails removal of the bladder and the prostate and diverting the urinary stream using parts of the intestine. This surgery will be described in the subsequent section on treatment of invasive bladder cancer.