Anthony Ciccone, Madonna’s oldest brother, died of respiratory failure and throat cancer according to a death certificate obtained by TMZ.

Ciccone’s death in February was reportedly caused by several health issues, including oropharyngeal cancer, with tobacco use being listed as a contributing factor, per the outlet.

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PEOPLE previously confirmed Ciccone’s death back in February, after Madonna’s brother-in-law, Joe Henry — who is married to the singer’s sister, Melanie Ciccone — announced the news on Instagram.

Ciccone was 66 at the time of his death, and TMZ reports that he had removed his breathing and feeding tube two days before his death, despite “dire consequences.”

“My brother-in-law, Anthony Gerard Ciccone, exited this earthly plane last evening,” Henry wrote in his caption. “I’ve known him since I was 15, in the spring of our lives in Michigan so many years now gone. As brother Dave Henry (who took this photograph) notes here, Anthony was a complex character; and god knows: we tangled in moments, as true brothers can.”

“But I loved him, and understood him better than I was sometimes willing to let on,” he continued. “But trouble fades; and family remains — with hands reached across the table. Farewell, then, brother Anthony. I want to think the god your blessed mother (and mine) believed in has her there, waiting to receive you. At least for today, no one shall dissuade me from this vision.”

A source told PEOPLE at the time that the pop superstar and her family had a complicated relationship with Ciccone because of his struggles. “They were all there for him and despite being estranged, Madonna supported him in every way she could when he was willing to take the support,” says the source. “Family members including Madonna visited him while in his rehab facility as he declined these past few months.”

Since his death, Madonna has credited her brother with introducing her to Charlie Parker, Miles Davis, Buddhism, Taoism, Charles Bukowski, Richard Brautigan, Jack Kerouac and “expansive thinking.”

“Thank you for blowing my mind as a young girl,” wrote Madonna, adding: “You planted many important seeds.”

In 2011, Ciccone said he was “homeless on the street” and living under a bridge in their native Michigan. Brother Christopher Ciccone told The Mirror in 2017 that he was “back home” and “recovering” after spending time in a treatment center.

Ciccone died in Suttons Bay, Mich. on Feb. 24, according to his obituary. He is described as an “insatiable reader” and “a deep lover of music with a wanderer’s spirit” in the obit, which also details his troubles and notes him as being “troubled and distant from his own, valued family.”

“Though a loner ––isolated throughout much of his adult life by the addiction that contributed to his early demise–– he was nonetheless enlivened by community and a sense of belonging,” it reads.

He is survived by his son Angelo Lawson-Smith, according to the obituary.