That's a pretty old version of Perl anyway. You may want to consider updating to 5.8.8 or 5.10.0 as an option.

The newer versions of the ActiveState distribution should have a working PPM system.

There's also Strawberry Perl to consider, which can build and install many (but not all) CPAN modules including those requiring a C compiler.

Either one should work for you. Some prefer Strawberry and some prefer ActiveState. There are even more options for Perl on Windows. I'd stick to one of the two already mentioned, though, unless you're using a full Unix compatibility environment on top of Windows (like CygWin or Interix).