In 1988, Matsuda was diagnosed with bladder cancer, before shooting began for Black Rain. Matsuda refused chemotherapy, as he thought it would affect his ability to act in the film. After his death, his first wife, who had experienced him ignoring an ear infection until it required surgery to prevent deafness, wrote that she suspected that he did not actually realize the seriousness of his illness. During the filming, he was urinating blood. By the time shooting finished, in March 1989, his cancer had spread to his spine and lungs, making it inoperable. On October 7, 1989, Matsuda was hospitalized. A month after he was admitted, Matsuda died at 6:45 PM JST on November 6 at the age of 40, at a Tokyo hospital. He was buried in Nishitama cemetery (西多摩霊園) in Akiruno, Tokyo.