Paul Reubens’ official cause of death has been revealed.
The late Pee-wee Herman actor’s death certificate, which was obtained by People on Friday, September 8, states that Reubens died of acute hypoxic respiratory failure. The condition occurs when there’s not enough oxygen or too much carbon dioxide in the body, which can be caused by many underlying conditions, according to The Cleveland Clinic.
The certificate also states that Reubens was also battling two forms of cancer: acute myelogenous leukemia and metastatic lung cancer. Acute myelogenous leukemia is a cancer of the blood and bone marrow, per the Mayo Clinic. Cancer Research UK defines metastatic lung cancer as an advanced kind of cancer that has spread from where it started in the lung.
Reubens died at age 70 in July. His death was confirmed via a statement on his Pee-wee Herman Instagram page.
“Last night we said farewell to Paul Reubens, an iconic American actor, comedian, writer and producer whose beloved character Pee-wee Herman delighted generations of children and adults with his positivity, whimsy and belief in the importance of kindness,” the message read. “Paul bravely and privately fought cancer for years with his trademark tenacity and wit. A gifted and prolific talent, he will forever live in the comedy pantheon and in our hearts as a treasured friend and man of remarkable character and generosity of spirit.”
The post also included a heartfelt message from the late actor apologizing for choosing to keep his cancer diagnosis to himself.
“Please accept my apology for not going public with what I’ve been facing the past six years,” Reubens shared. “I have always felt a huge amount of love and respect from my friends, fans and supporters. I have loved you all so much and enjoyed making art for you.”
In addition to his sentiments, Reubens’ final wish was for any “expressions of sympathy” to be made to Stand Up to Cancer or any dementia or Alzheimer’s organization in honor of his late parents.
Reubens created his iconic character while he was a member of the Los Angeles improv troupe The Groundlings in the 1980s. He brought the childlike alter ego to life onstage before getting his big break onscreen in Pee-wee’s Big Adventure in 1985. He continued to bring the character to life with his 1986 children’s TV program Pee-wee’s Playhouse for five seasons.
Despite the show’s ending, Reubens did not retire from the role. Over the years, he brought Herman back to the stage and the big screen for a 2011 Broadway stint and the 2016 film Pee-wee’s Big Holiday.