Madonna’s older brother’s cause of death was finally revealed weeks after his death.

Anthony Ciccone died of a number of illnesses, including throat cancer and respiratory failure. According to the tabloid TMZ, oropharyngeal cancer caused by smoking contributed to his death at the age of 66.

Ciccone died on February 25 while receiving treatment at a nursing home in Michigan, which was paid for by his famous sister, Madonna. According to TMZ, Anthony requested that his feeding and breathing tubes be removed two days before he died, even though he knew it would be fatal.

Joseph Henry, the husband of Madonna’s younger sister Melanie Ciccone, paid his respects on Instagram. He shared a photo of Ciccone as a young man and announced that his brother-in-law, Anthony Gerard Ciccone, whom he had known since they were both youngsters in Michigan many years ago, had passed away. Ciccone was a complicated guy, Henry said, and they had their disagreements like real brothers, but he loved and knew him better than he was often willing to admit.

Madonna shared an emotional tribute to her brother on social media two days after his death. She thanked him for introducing her to music celebrities and philosophies that had inspired her as a child and adult. Despite their growing estrangement over the years, Madonna is said to have paid for her troubled brother’s hospital stay and supported him from afar.

According to a People Magazine source, they were all there for him, and despite their sometimes strained relationship, Madonna helped him in any way she could when he was ready to receive it. When his condition began to deteriorate, Madonna and other family members paid him visits while he was receiving treatment.

Ciccone was two years Madonna’s senior and the eldest of her five siblings, born in Michigan to Catholic parents. His relationship with his family had often been strained as he struggled with homelessness and alcoholism, reportedly refusing to accept charity from his celebrity sister.