Val Kilmer’s official cause of death has been revealed.
Over a week since his family confirmed the actor’s death at age 65 on April 1, Kilmer’s official cause of death has been ruled as pneumonia according to a death certificate obtained by TMZ and reviewed by PEOPLE.
Underlying causes listed on Kilmer’s death certificate include acute hypoxemic respiratory failure, chronic respiratory failure, and squamous cell carcinoma of the base of the tongue.
Kilmer’s body was also cremated on April 7.
The announcement aligns with what the late star’s daughter Mercedes shared with The New York Times. Mercedes, 33, told the outlet that he died of pneumonia.
She also noted that Kilmer was diagnosed with throat cancer in 2014, and later recovered.
Related: Inside Val Kilmer’s Decade-Long Health Struggles Before His Death from Pneumonia at 65
Years before his death, the actor — best known for movies 1986’s Top Gun, 1991’s The Doors and 1995’s Batman Forever — opened up about his cancer journey in a rare interview with The Hollywood Reporter.
After two years living with the disease, it had “taken its toll,” per the December 2017 article, which followed years of speculation about his health.
Addressing this period marked by rampant rumors about his health in his 2020 memoir, I’m Your Huckleberry, the star wrote, “Reports emerged that I was in denial. Well, denial is a funny thing. I was not denying that I had had cancer but was simply saying I no longer did.”
“And to be honest,” he continued, “it was very hard to embrace my original diagnosis. It was surreal. I didn’t believe I was decomposing, and I wasn’t ready to die.”
Related: Val Kilmer’s Life in Photos
In I’m Your Huckleberry, Kilmer also delved deeper into his health struggles during this time, including how he ignored some of his symptoms before he was hospitalized for throat cancer.
In 2014, the Top Gun star was forced to cancel his one-man show after losing his voice, Kilmer revealed in the memoir. At the time, he also noticed a lump in his throat and realized it had become hard to swallow, but didn’t seek medical attention until the following year.
“One night I suddenly awoke vomiting blood that covered the bed like a scene out of The Godfather,” Kilmer wrote, recalling that he “prayed immediately, then called 911.”
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Following the harrowing experience, which landed him in the hospital, Kilmer learned that the lump in his throat was cancer, later undergoing a tracheotomy, chemotherapy and radiation. “The prognosis did not look good,” Mercedes later told PEOPLE of the difficult moment.
In his 2020 memoir, Kilmer said had “been healed of cancer for over four years,” with no recurrences. And, as of his September 2021 PEOPLE cover story, he was still cancer-free.
“There are things we do every day to soothe the vocal cords and to repair them, but they’re very damaged,” his son, Jack, told PEOPLE at the time. “He doesn’t seem to be in pain when he speaks. Sometimes you can’t shut him up.”
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