Pancreatic cancer with distant lymph node metastasis to the right supraclavicular bone belongs to the advanced stage of pancreatic cancer, which can be treated by chemotherapy, radiotherapy and targeted/immunotherapy. When pancreatic cancer with distant lymph node metastasis belongs to stage IV pancreatic cancer, which is in advanced stage, the effect of surgical treatment is generally unsatisfactory, and basically the chance of complete surgical resection has been lost. Chemotherapy is available for advanced pancreatic cancer. Those with better physical status preferred combination treatment programs, such as FOLFIRINOX, gemcitabine combined with albumin-binding paclitaxel or gemcitabine combined with Tegretol, etc.; those with poor physical status can choose gemcitabine or Tegretol single-agent program. Chemotherapy may cause myelosuppression and other adverse reactions, and should be used under the guidance of specialized doctors. Radiotherapy, i.e. radiation therapy, sends out rays through instruments to kill tumor cells. At present, the main type of radiotherapy used is stereotactic radiotherapy with multi-beam focusing, and the radiation dose and course can be reasonably selected according to the size and stage of the tumor. MSI, MMR and TMB tests should be performed for all patients with advanced pancreatic cancer. Immune checkpoint inhibitors such as PD-1 monoclonal antibody are recommended for the treatment of metastatic pancreatic cancer patients with highly microsatellite instability or mismatch repair-deficient molecular features. If pancreatic cancer is suspected or diagnosed, it is recommended to go to a regular hospital to evaluate the condition and follow the doctor’s instructions to cooperate with the treatment in order to improve the patient’s prognosis and prolong the survival period. Please strictly follow the doctor’s instructions for drug treatment and do not use drugs by yourself.