Councillor Rob Ford, whose tumultuous four years as mayor of Toronto turned him into an international cultural phenomenon, died on Tuesday at Torontos Mount Sinai Hospital. He was 46.

Official word of his death came from a source close to the family. His passing marks the end of a rare political actor whose everyman persona, budget-slashing agenda and very public substance-abuse issues inspired both intense loyalty and deep loathing among the city’s diverse electorate.

It also ends an 18-month struggle with cancer.

Mr. Ford had been diagnosed with pleomorphic liposarcoma, a rare form of soft-tissue cancer, in September of 2014, amid a heated re-election battle. The illness forced him to withdraw his candidacy for a second term to focus on cancer treatments.

He underwent an aggressive round of treatment followed by surgery to remove a tumour last May. By September, he had declared himself cancer-free and appeared at Stephen Harper’s side during the federal election campaign.

The clean bill of health was short-lived. In late October, doctors found new tumours and commenced another round of chemotherapy.

Since then, his chair on the council floor has been notably vacant and his office staff ceased sending out his trademark pugilistic press releases, which routinely taunted his successor in the mayor’s office, John Tory.

This month, his battle took on a desperate new tone. The Ford family launched getwellrobford.com to collect messages from sympathizers and turned to experimental treatments.

On Thursday, as speculation about the former mayor’s condition began swirling on social media, Mr. Ford’s chief of staff, Dan Jacobs, issued a brief statement acknowledging that Mr. Ford was in hospital “as he continues his battle against cancer.”

The son of a well-known Etobicoke businessman and former provincial MPP, Mr. Ford left the family label business to win a council seat in 2000. Re-elected twice, he turned his attentions to the mayoralty in 2010, launching a long-shot campaign for the city’s highest office. He quickly tapped into a vein of suburban resentment toward urban elements of the recently amalgamated megacity, and trounced his nearest opponent.

His small-government agenda ran afoul of left-wing politicians and unions, but his bedrock of support – which he affectionately referred to as Ford Nation – only began to erode in May, 2013, after stories emerged on the U.S. website Gawker and the Toronto Star about a video showing the mayor smoking what appeared to be crack cocaine. The revelations touched off a Toronto Police investigation and a ceaseless lampooning on U.S. late-night talk shows hosted by the likes of Jon Stewart, Jimmy Kimmel and Jay Leno.

Mr. Ford vehemently denied the accusations until abruptly reversing himself in November, admitting to a throng of reporters, “Yes, I have smoked crack cocaine.”

Though damning details eventually emerged from the police investigation and a second crack video eventually surfaced, Mr. Ford maintained support until his cancer diagnosis.

When the tumour derailed his campaign, his brother, Councillor Doug Ford, entered the race, eventually losing to Mr. Tory.

After the results rolled in, Rob Ford vowed he would unseat Mr. Tory in 2018, as soon as his health improved.

“I will continue to fight,” the former mayor said. “I will continue to fight. Trust me. I’m just warming up.”