How large is the performance loss for Coppermine to use MySQL 5 over MySQL 4?
Unknown.
What are the suggested changes to the my.cnf file to ensure the fastest page loads?
There are no suggested changes from our side.
We're running rather slowly.
Posting a link to your gallery might help more than posting the server hardware details.
Also, does Coppermine support XCache or APC?
Coppermine was not designed for the using with particular cache modules or similar. There is no query caching in coppermine. Simple answer is "no". I'm not even aware of the names you mentioned - in fact I'm just guessing that those are database query caches.