Jerry,
You've come to the right place.
Here is a link to the flow chart that George just mentioned:
Bladder Cancer Flow Chart
Some folks have printed it out and taken it to their urologist to help facilitate the discussion.
First: Bladder cancer is a VERY TREATABLE disease. There are folks here who had it 15 years ago or so. Not a lot of them posting because many have moved on with their lives and put the whole bladder cancer thing behind them. Some of us others have been around for a few years or more but we got a lot from this site when we were where you are now so we hang around and try to give back to others.
The elevated PSA does NOT mean that it has spread to your prostate. Let's just focus on the bladder tumor for now and then you can get back to checking the prostate later.
There are probably visual charactistics of the tumor that your doc has seen that are usually bladder cancer. It may or may not be and the procedure TURBT (TransUrethral Resection of a Bladder Tumor) will tell. What is important and you will see it on the chart is determining the stage and grade. There are MANY more low grade bladder cancers discovered every year than high grade. Low grade is slow growing and high grade is faster. Most tumors are caught when they are still non-invasive (sometimes called superficial because they are only on the innermost lining of the bladder--but there is big deal about calling any cancer 'superficial' so we usually just say non-invasive).
During the TURBT, they remove the tumor by going through a cystoscope into your bladder and they use a little metal loop that is electrified so it can cut the tumor away along with bladder tissue under the tumor. The reason you need a second one 6 weeks later is bladder cancer is often understaged the first time and you also want to make sure there was no seeding (cancer cells get loose and attach to another part of the bladder wall).
While I know you are probably pretty freaked out right now, when caught early, bladder cancer is very treatable. Look around this site for information and read up. Ask any questions that come to mind.
Even if you have it (which you don't know yet) you will be OK. Lot's of things can be done.
We are here for you!
Mike