Poor Paul Reubens.

A little over a month after the Pee-wee’s Big Adventure actor sadly passed away, more details have surfaced about what exactly it was that took his life. At the time of his death, a posthumous statement released on his Instagram revealed that he had been in a private, six-year battle with cancer before he died at 70 years old.

Over the weekend, People obtained the actor’s death certificate, which revealed that his official cause of death had been listed as acute hypoxic respiratory failure. According to Healthine, the deadly ailment occurs when “your lungs cannot release enough oxygen into your blood, which prevents your organs from properly functioning. It also occurs if your lungs cannot remove carbon dioxide from your blood.”

So, so sad.

Paul’s two forms of cancer were the underlying causes — the primary was acute myelogenous leukemia, a blood and bone marrow cancer, while the secondary was metastatic lung cancer, which he had only been diagnosed with months before his passing.

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How sad. We are sending lots of love to all of Paul’s dear ones. Rest in peace.

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