Yes, but the difference is that if a user has permission to run mod_perl as part of a shared server environment that user can load leaky C code - custom C modules for php would have to be compiled into the server by the administrator.
apache internals - that's why it's so powerful. You can do anything with mod_perl that you could do with a C module (making it great for prototyping apache C modules). The only things PHP can modify are selected PHP settings and the server output.